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NPI Provider: 1598761033
Contact Name: Ackers Charles
Position: Administrator
Phone: (309) 837-5482
Elms, The Information:
Elms, The organization have npi 1598761033, taxonomy code is 314000000X with license number is 21568 in . This Business address located in 1212 Madelyn Ave, Macomb, IL 61455 Illinois. Get directions of Elms, The.
Practice Location
Address: 1212 Madelyn Ave, Macomb, IL 61455
Phone: (309) 837-5482
Business Location
Address: 1212 Madelyn Ave, Macomb, IL 61455
Phone: (309) 837-5482
Fax: (309) 833-1054
Taxonomy
Taxonomy Code: 314000000X
License Number: 21568
License Number of State: IL
Primary Taxonomy Switch: Y
Enumeration Date: 6/21/2005
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