Healthcare Provider Details

I. General information

NPI: 1437067881
Provider Name (Legal Business Name): DANVILLE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3545 N VERMILION ST
DANVILLE IL
61832-1100
US

IV. Provider business mailing address

3545 N VERMILION ST
DANVILLE IL
61832-1100
US

V. Phone/Fax

Practice location:
  • Phone: 217-651-6801
  • Fax:
Mailing address:
  • Phone: 217-651-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSICA NEMECZ
Title or Position: CEO
Credential: LCPC, LMHC
Phone: 217-637-5172