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General NPI Number Information
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NPI Number | 1316281868
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Entity Type | Organization
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Legal Business Name | UNIVERSAL WALK-IN URGENT CARE LLC
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Dates
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Enumeration Date | 11/23/2012
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Last Update Date | 11/23/2012
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Provider Practice Location Address
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Address Line | 3767 E US ROUTE 36
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City | DECATUR
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State | IL
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Zip | 62521-5085
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Country | US
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Telephone | 217-330-6153
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Fax |
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Provider Business Mailing Address
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Address Line | 3767 E US ROUTE 36
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City | DECATUR
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State | IL
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Zip | 62521-5085
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Country | US
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Telephone | 217-330-6153
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Fax |
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Authorized Official
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Title or Position | OWNDER
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Name | DR. SUKHWINDER S MULTANI
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Credential | MD
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Telephone | 217-330-6153
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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