Healthcare Provider Details
I. General information
NPI: 1831156124
Provider Name (Legal Business Name): THE CARLE FOUNDATION HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2006
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 N GILBERT ST STE F
DANVILLE IL
61832-8504
US
IV. Provider business mailing address
611 W PARK
URBANA IL
61801
US
V. Phone/Fax
- Phone: 217-446-0577
- Fax: 217-446-1060
- Phone: 217-383-3311
- Fax: 217-446-1060
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMES
LEONARD
Title or Position: CEO
Credential: MD
Phone: 217-383-3220