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General NPI Number Information
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NPI Number | 1225996580
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Entity Type | Organization
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Legal Business Name | CARLE HEALTH CARE INCORPORATED
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Dates
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Enumeration Date | 01/14/2026
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Last Update Date | 01/14/2026
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Provider Practice Location Address
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Address Line | 4116 FIELDSTONE RD
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City | CHAMPAIGN
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State | IL
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Zip | 61822-8801
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Country | US
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Telephone | 217-902-3130
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Fax |
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Provider Business Mailing Address
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Address Line | 3310 FIELDS SOUTH DR
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City | CHAMPAIGN
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State | IL
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Zip | 61822-3741
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Country | US
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Telephone | 217-902-5291
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Fax | 217-902-7711
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | MATTHEW KOLB
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Credential |
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Telephone | 217-383-4337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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