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General NPI Number Information
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NPI Number | 1285049072
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Entity Type | Organization
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Legal Business Name | CARLE HOSPITAL
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Dates
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Enumeration Date | 07/01/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 611 W PARK ST
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City | URBANA
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State | IL
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Zip | 61801-2529
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Country | US
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Telephone | 408-838-8412
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Fax |
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Provider Business Mailing Address
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Address Line | 502 W MAIN ST APARTMENT #318
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City | URBANA
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State | IL
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Zip | 61801-2574
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Country | US
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Telephone | 408-838-8412
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Fax |
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Authorized Official
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Title or Position | RESIDENT
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Name | DAVID CHIANG
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Credential |
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Telephone | 408-838-8412
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State | IL
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