Provider Demographics
NPI:1285838151
Name:ECARE EMERGENCY PHYSICIANS
Entity Type:Organization
Organization Name:ECARE EMERGENCY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:CANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-960-2299
Mailing Address - Street 1:26 W WEST NEWELL RD
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61834-7488
Mailing Address - Country:US
Mailing Address - Phone:217-446-1400
Mailing Address - Fax:217-446-5907
Practice Address - Street 1:26 W WEST NEWELL RD
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61834-7488
Practice Address - Country:US
Practice Address - Phone:217-446-1400
Practice Address - Fax:217-446-5907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7002363261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER