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General NPI Number Information
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NPI Number | 1639461338
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Entity Type | Organization
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Legal Business Name | VERMILION COUNTY HEALTHCARE, INC.
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Dates
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Enumeration Date | 05/12/2011
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Last Update Date | 05/12/2011
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Provider Practice Location Address
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Address Line | 715 W FAIRCHILD ST
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City | DANVILLE
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State | IL
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Zip | 61832-3795
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Country | US
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Telephone | 217-446-1100
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Fax | 217-446-1101
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Provider Business Mailing Address
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Address Line | 715 W FAIRCHILD ST
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City | DANVILLE
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State | IL
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Zip | 61832-3795
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Country | US
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Telephone | 217-446-1100
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Fax | 217-446-1101
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Authorized Official
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Title or Position | PHYSICAN ASSISTANT/CEO
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Name | JULIE ANN HOLYCROSS
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Credential | PA-C
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Telephone | 217-446-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 085002684
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 036103275
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License Number State | IL
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