TAKE CARE HEALTH SERVICES PA

Provider Demographics

• NPI: 1689865818
• Name: TAKE CARE HEALTH SERVICES PA
• Entity Type: Organization
• Organization Name: TAKE CARE HEALTH SERVICES PA
• Authorized Official - Title/Position: ASSISTANT SECRETARY
• Authorized Official - First Name: DEBORAH
• Authorized Official - Last Name: HEGG
• Authorized Official - Phone: 217-709-2469
• Mailing Address - Street 1: 1901 E VOORHEES ST
• Mailing Address - Street 2: MS 640
• Mailing Address - City: DANVILLE
• Mailing Address - State: IL
• Mailing Address - Zip Code: 61832-4509
• Mailing Address - Country: US
• Mailing Address - Phone: 855-925-4733
• Mailing Address - Fax: 217-709-2345
• Practice Address - Street 1: 408 E MICHIGAN ST
• Practice Address - City: ORLANDO
• Practice Address - State: FL
• Practice Address - Zip Code: 32806-4542
• Practice Address - Country: US
• Practice Address - Phone: 855-925-4733
• Practice Address - Fax: 217-709-2345
• EIN: <UNAVAIL>
• Is Organization Subpart?: No
• Enumeration Date: 2007-08-05
• Last Update Date: 2019-03-20

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
FL	0012255-11	Medicaid
FL	0012255-34	Medicaid
FL	0012255-39	Medicaid
FL	0012255-40	Medicaid
FL	0012255-16	Medicaid
FL	0012255-24	Medicaid
FL	0012255-25	Medicaid
FL	0012255-42	Medicaid
FL	0012255-09	Medicaid
FL	0012255-18	Medicaid
FL	0012255-19	Medicaid
FL	0012255-23	Medicaid
FL	0012255-43	Medicaid
FL	0012255-01	Medicaid
FL	0012255-03	Medicaid
FL	0012255-06	Medicaid
FL	0012255-08	Medicaid
FL	0012255-17	Medicaid
FL	0012255-26	Medicaid
FL	0012255-35	Medicaid
FL	0012255-37	Medicaid
FL	0012255-46	Medicaid
FL	0012255-07	Medicaid
FL	0012255-14	Medicaid
FL	0012255-15	Medicaid
FL	0012255-28	Medicaid
FL	0012255-41	Medicaid
FL	0012255-45	Medicaid
FL	0012255-48	Medicaid
FL	0012255-02	Medicaid
FL	0012255-04	Medicaid
FL	0012255-10	Medicaid
FL	0012255-27	Medicaid
FL	0012255-30	Medicaid
FL	0012255-47	Medicaid
FL	0012255-13	Medicaid
FL	0012255-20	Medicaid
FL	0012255-22	Medicaid
FL	0012255-31	Medicaid
FL	0012255-38	Medicaid
FL	0012255-44	Medicaid
FL	0012255-05	Medicaid
FL	0012255-12	Medicaid
FL	0012255-21	Medicaid
FL	0012255-29	Medicaid
FL	0012255-32	Medicaid
FL	0012255-36	Medicaid
FL	0012255-27	Medicaid
FL	0012255-32	Medicaid
FL	0012255-41	Medicaid