Provider Demographics
NPI:1972782845
Name:NATIONALHEALTHCAREINC
Entity Type:Organization
Organization Name:NATIONALHEALTHCAREINC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:VAN DUYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-691-9073
Mailing Address - Street 1:7405 N UNIVERSITY ST # D
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61614-1212
Mailing Address - Country:US
Mailing Address - Phone:309-691-9073
Mailing Address - Fax:309-691-4528
Practice Address - Street 1:7405 N UNIVERSITY ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61614-1212
Practice Address - Country:US
Practice Address - Phone:309-691-9073
Practice Address - Fax:309-691-4528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL7001670261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical