Gibson Community Hospital Association
Organization Active NPI Family Medicine Physician · Onarga, IL
NPI 1023218534 · NPPES record last updated Aug 28, 2007
Key facts
- NPI
- 1023218534
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- GIBSON COMMUNITY HOSPITAL ASSOCIATION
- Practice address
- 109 N Chestnut St
Onarga, IL 60955-1255 - Phone
- (815) 268-4841
- Fax
- (815) 268-4845
- NPI assigned
- Jul 23, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Jan E Wilson
- Title
- Office Manager
- Phone
- (815) 268-4840
Other NPIs on the same Medicare enrollment 38
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040505001293 | IL | Part B Supplier - Clinic/Group Practice | 5092703124 |
Receives reassigned benefits from 201 practitioners 38 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Watseka, IL; Urbana, IL; Paxton, IL; Fairbury, IL; Onarga, IL; Mahomet, IL; Hoopeston, IL; Gibson City, IL… |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | IL | Yes |
Addresses
Primary practice location
109 N Chestnut St
Onarga, IL 60955-1255
Mailing address
109 N Chestnut St
Onarga, IL 60955-1255
Phone (815) 268-4841
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 208576 | Other | IL | MEDICARE GROUP |
Other names
- THE ONARGA CLINIC
Other providers in Onarga, IL
- Shelby Clubb
- E David Noh PC
- Katherine M Fox
- Gibson Community Hospital Association
- Beth Gomez
- Susan Kay Gray
- Iroqouois Mental Health Center
- Iroquois Mental Health Center
All providers in Onarga, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 28, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.