Decatur Digestive Disease Center Llc in Decatur - Ambulatory Surgical
Decatur Digestive Disease Center Llc - NPI 1134185564
Decatur Digestive Disease Center Llc is a Ambulatory Surgical in Decatur, Illinois. Decatur Digestive Disease Center Llc practices all healthcare services and medical treatments related to Ambulatory Surgical. The NPI Number for Decatur Digestive Disease Center Llc is 1134185564. The last update date is 2013-04-01.
Decatur Digestive Disease Center Llc's current location address is 2 Memorial Dr Suite 102, Decatur, Illinois. You can contact this provider via phone number 2172330003 and fax number 2172330077. The mailing address for Decatur Digestive Disease Center Llc is 2 Memorial Dr Suite 102, Decatur, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Decatur Digestive Disease Center Llc |
|---|---|
| Address | 2 Memorial Dr Suite 102, Decatur, Illinois |
| Phone Number | 2172330003 |
| Fax Number | 2172330077 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Eloy Victor |
| Credentials | MD |
| Telephone Number | 2172330003 |
NPI Number Detail
| NPI Number | 1134185564 |
|---|---|
| Provider Enumeration Date | 2006-04-25 |
| Last Updated Date | 2013-04-01 |
Provider Mailing Address Detail
| Address | 2 Memorial Dr Suite 102 |
|---|---|
| City | Decatur |
| State | Illinois (IL) |
| Post Code | 625263950 |
| Phone Number | 2172330003 |
| Fax Number | 2172330077 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Surgical |
|---|---|
| Taxonomy | 261Qa1903X |
| Licence No | 7002983 |
|
Definition: Provides outpatient surgical services not requiring hospitalization. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 50402 | IL | BLUE CROSS BLUE SHIELD | |
| P00257307 | IL | MEDICARE RAILROAD |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Decatur Digestive Disease Center Llc by the Centers for Medicare & Medicaid Services?
The Decatur Digestive Disease Center Llc has been issued the NPI (National Provider Identifier) 1134185564, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete physical location address of Decatur Digestive Disease Center Llc?
The Decatur Digestive Disease Center Llc is physically situated at 2 Memorial Dr Suite 102, in the city of Decatur, state of IL, with the postal code 625263950.
What is Decatur Digestive Disease Center Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Decatur Digestive Disease Center Llc's specialized field of practice is Ambulatory Surgical, and the corresponding taxonomy code that categorizes this area of specialization is 261Qa1903X.
On what date was the 1134185564 assigned to Decatur Digestive Disease Center Llc?
The Decatur Digestive Disease Center Llc was issued its 1134185564 on 2006-04-25, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Decatur Digestive Disease Center Llc most recently updated or revised?
The information pertaining to Decatur Digestive Disease Center Llc, including its address, specialty, and other relevant details, was last updated or revised on 2013-04-01.