Provider Demographics
NPI:1992038640
Name:BLESSINGCARE CORPORATION
Entity Type:Organization
Organization Name:BLESSINGCARE CORPORATION
Other - Org Name:ILLINI COMMUNTIY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE, CAO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-223-8400
Mailing Address - Street 1:1005 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2834
Mailing Address - Country:US
Mailing Address - Phone:217-223-8400
Mailing Address - Fax:217-223-9945
Practice Address - Street 1:640 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:IL
Practice Address - Zip Code:62363-1350
Practice Address - Country:US
Practice Address - Phone:217-285-2113
Practice Address - Fax:217-285-2989
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BLESSINGCARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0005132207P00000X
207PE0004X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty