Healthcare Provider Details

I. General information

NPI: 1164764635
Provider Name (Legal Business Name): REGIONAL HEALTH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2013
Last Update Date: 03/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1258 W SOUTH ST STE 2
KEWANEE IL
61443-8300
US

IV. Provider business mailing address

PO BOX 86
GALVA IL
61434-0086
US

V. Phone/Fax

Practice location:
  • Phone: 309-853-3677
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RICK SEIDLER
Title or Position: PRESIDENT & CEO
Credential:
Phone: 309-779-5000