Provider Demographics
NPI:1770358871
Name:CHAMBANA URGENT CARE AND WALK IN CLINIC
Entity type:Organization
Organization Name:CHAMBANA URGENT CARE AND WALK IN CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:ARSHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAVED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:872-346-8918
Mailing Address - Street 1:1907 W SPRINGFIELD AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61821-3098
Mailing Address - Country:US
Mailing Address - Phone:872-346-8918
Mailing Address - Fax:217-328-6054
Practice Address - Street 1:1907 W SPRINGFIELD AVE STE B
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61821-3098
Practice Address - Country:US
Practice Address - Phone:872-346-8918
Practice Address - Fax:217-328-6054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-17
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care