=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841358546
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACCURACY URGENT CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/05/2006
-----------------------------------------------------
Last Update Date | 06/16/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 805 W DEYOUNG ST SUITE E
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62959-1604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-998-1900
-----------------------------------------------------
Fax | 618-998-1990
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 805 W DEYOUNG ST SUITE E
-----------------------------------------------------
City | MARION
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62959-1604
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-998-1900
-----------------------------------------------------
Fax | 618-998-1990
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | MS. DONNETTA MARIE BYRLEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 618-998-1900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 173000000X
-----------------------------------------------------
Taxonomy Name | Legal Medicine
-----------------------------------------------------
License Number | 036-104784
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------