Medical Income Management Corp
Organization Active NPI Family Medicine Physician · Sullivan, IL
NPI 1912924630 · NPPES record last updated Apr 24, 2009
Key facts
- NPI
- 1912924630
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- MEDICAL INCOME MANAGEMENT CORP
- Practice address
- 101 W Jefferson St
Sullivan, IL 61951-1914 - Phone
- (217) 728-9999
- NPI assigned
- Jul 17, 2006
- Organization subpart
- No
Authorized official
- Name
- Kurt M Dearnbarger, MD
- Title
- Owner
- Phone
- (217) 728-9999
Practitioners 4
-
Kurt M Dearnbarger, M.D.
-
Jacqueline R Clayton, APN
-
Judith Lidy, FNP
National Provider Directory
Locations
506 W Lincoln Ave
Charleston, IL 61920
Phone (217) 348-3339
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
101 W Jefferson St
Sullivan, IL 61951-1914
Mailing address
PO Box 1215
Mattoon, IL 61938-1215
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00329285 | Other | RETIRED RAILROAD | |
| P00151494 | Other | IL | RAILROAD MEDICARE PALMETTO GBA |
| 036092940 | Medicaid | IL |
Other providers in Sullivan, IL
- Lindsey Lefever
- Danielle Linder
- Madeli Therapy LLC
- Alexa Matthies
- Tabitha McMichael
- Macie Anna Miller
- Natalie Mitchem
- Audrey Mosier
- Moultrie Co
- Moultrie County Beacon
All providers in Sullivan, 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 Apr 24, 2009. 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.