COUNTY OF MACON

NPI # 

Practice Address:

1221 E Condit St

Decatur, IL, 62521-1405

Practice Phone:

217-423-6988

Practice Fax:

217-423-5079

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Health Service

Taxonomy Code:

261QH0100X