Provena Service Corporation
Pediatrics
Provena Service Corporation is a Danville, Illinois based Pediatric center with medical specialization in
General Pediatrics. Provena Service Corporation is doing business as
Provena Medical Group.
It is located at
102 N Logan Ave, Danville, Illinois - 61832-8513. They can be contacted on phone at
217-442-5863 and fax number 217-442-5040.
NPI number (Unique professional ID) for Provena Service Corporation is
1255526687 which was assigned by NPPES on 10 Sep, 2007 and it was last updated on 20 Apr, 2008.
Provena Service Corporation is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Provena Service Corporation basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Provena Service Corporation |
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| Other Name : | Provena Medical Group |
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Business Address:
Provena Service Corporation address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 102 N Logan Ave
Danville, IL, 61832-8513
United States |
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| Phone Number : | 217-442-5863 |
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| Fax Number : | 217-442-5040 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1255526687 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 10 Sep, 2007 |
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| Last Updated On : | 20 Apr, 2008 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Daniel Boland |
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| Official Title or Position : | FINANCIAL REPORTING MANAGER |
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| Phone Number : | 815-806-3111 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Provena Service Corporation are as mentioned. Primary taxonomy code for Provena Service Corporation is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | | IL |
Legacy Identifiers:
Other legacy medical identifiers of Provena Service Corporation such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| =========003 | MEDICAID | IL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 9223 W Saint Francis Rd
Frankfort, IL, 60423-8330
United States |
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| Phone Number : | 815-806-3111 |
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Business Location:
Patients can refer following map for directions to
Provena Service Corporation practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.