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NPI Code Detail

MEDICARE: CARLE BROMENN MEDICAL CENTER

MEDICARE: CARLE BROMENN MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1273Y00000XRehabilitation Hospital Unit1748518IL

General Provider Information

NPI Number : 1306867866
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARLE BROMENN MEDICAL CENTER
Provider Business Mailing Address
First Line : 1304 FRANKLIN AVE
Second Line :
City : NORMAL
State : IL
Zip : 61761-3558
Country : US
Telephone Number : 309-454-1400
Fax Number :
Provider Business Practice Location Address
First Line : 1304 FRANKLIN AVE
Second Line :
City : NORMAL
State : IL
Zip : 61761-3558
Country : US
Telephone Number : 309-454-1400
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT FINANCE
Name : ARON KLEIN
Credential :
Telephone Number : 309-268-2410
Provider Enumeration Date : 07/21/2006
Last Update Date : 10/19/2020

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