MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC; NPI #1568619088

Contact Information

MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC

203 S. MAIN ST.
DIETERICH, IL 62424

Phone: 217-925-5730
Fax: 217-925-5736
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rural Health	261QR1300X	B4[14]	Rural Health Clinic

Indicates primary specialty

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NPI Profile & details for MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC

NPI # 1568619088

LBN Legal business name MID-ILLINOIS MEDICAL CARE ASSOCIATES, LLC

Authorized official EUGENE DUST - (PRESIDENT OF MID-ILLINOIS MEDICAL C)

Entity Organization

Organization subpart ¹ Yes

Enumeration date 08/27/2008

Last updated 06/27/2017 - About 9 years ago

Identifiers

IL	License #	036120332
IL	Medicaid	036120332

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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