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General NPI Number Information
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NPI Number | 1437275328
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Entity Type | Organization
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Legal Business Name | THE CARLE FOUNDATION HOSPITAL
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 05/10/2013
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Provider Practice Location Address
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Address Line | 5731 PARK DR
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City | CHARLESTON
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State | IL
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Zip | 61920-9466
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Country | US
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Telephone | 217-258-3640
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Fax | 217-258-3648
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Provider Business Mailing 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 | 61801-2500
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Country | US
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Telephone | 217-383-3220
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Fax | 217-383-3018
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. JAMES C LEONARD
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Credential | MD
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Telephone | 217-326-4677
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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