Ambulatory Medical Associates LLC
Organization Active NPI Primary Care Clinic/Center · Normal, IL
NPI 1306040878 · NPPES record last updated Nov 20, 2013
Key facts
- NPI
- 1306040878
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- License
- 036094859 (IL)
- Legal business name
- AMBULATORY MEDICAL ASSOCIATES LLC
- Practice address
- 2010 Jacobssen Dr
Normal, IL 61761-6280 - Phone
- (309) 452-0995
- Fax
- (309) 862-0961
- NPI assigned
- Jun 11, 2007
- Organization subpart
- No
Authorized official
- Name
- Phoebe Panopio, MD
- Title
- Dr
- Phone
- (309) 452-0995
National Provider Directory
Locations
2010 Jacobssen Dr
Ste B
Normal, IL 61761
Phone (309) 452-0995
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 036094859 | IL | Yes |
Addresses
Primary practice location
2010 Jacobssen Dr
Normal, IL 61761-6280
Mailing address
2010 Jacobssen Dr
Normal, IL 61761-6280
Phone (309) 452-0995
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.