MEDICARE: CHAMPAIGN COUNTY

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
1	332BN1400X	Nursing Facility Supplies (DME)	001636	IL
2	332BP3500X	Parenteral & Enteral Nutrition Supplies (DME)	001636	IL
3	313M00000X	Nursing Facility/Intermediate Care Facility	0001636	IL
4	314000000X	Skilled Nursing Facility	0001636	IL

General Provider Information

NPI Number	:	1982602330
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAMPAIGN COUNTY

Provider Business Mailing Address
First Line	:	500 SOUTH ART BARTELL ROAD
Second Line	:
City	:	URBANA
State	:	IL
Zip	:	61802
Country	:	US
Telephone Number	:	217-384-3784
Fax Number	:	217-337-0120

Provider Business Practice Location Address
First Line	:	500 SOUTH ART BARTELL ROAD
Second Line	:
City	:	URBANA
State	:	IL
Zip	:	61802
Country	:	US
Telephone Number	:	217-384-3874
Fax Number	:	217-337-0120

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. KAREN L NOFFKE
Credential	:	RN
Telephone Number	:	217-693-5015

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	03/04/2013

Similar Medicare Providers

1922003326 — CLARK-LINDSEY VILLAGE, INC.
Practice Location Address:

101 W WINDSOR RD
URBANA, IL
61802-6663

Practice Phone: 217-344-2144
Practice Fax: 217-344-9147

1619973021 — DR. ALBERT GREGORY NACHOWICZ DPM
Practice Location Address:

2406 E UNIVERSITY AVE , STE 1
URBANA, IL
61802-6204

Practice Phone: 217-384-2071
Practice Fax: 217-384-2095

1306838503 — DR. AHMED TAREK ELRAKHAWY M.D.
Practice Location Address:

1818 E WINDSOR RD
URBANA, IL
61802-9566

Practice Phone: 217-255-9646
Practice Fax: 217-326-1777

1720056385 — MARK DAVID RIEGER ATC
Practice Location Address:

810 W ANTHONY DR
URBANA, IL
61802-7431

Practice Phone: 217-383-6992
Practice Fax:

1427026962 — STEPHANIE ANN KAISER ATC/L
Practice Location Address:

810 W ANTHONY DR
URBANA, IL
61802-7431

Practice Phone: 217-383-4237
Practice Fax:

1073581492 — JOHN FLANNELL MS, ATC
Practice Location Address:

810 W ANTHONY DR
URBANA, IL
61802-7431

Practice Phone: 217-326-1912
Practice Fax: 217-326-2368

Directions to “CHAMPAIGN COUNTY ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.