Fountain Healthcare Limited Liability Company
Fountain Healthcare Limited Liability Company provides Adult Medicine Physician services in Streator, Illinois. Licensed in Illinois. Registered with an NPI since 2012.
- Licensed in
- IL
- In the registry since
- 2012
Practice location Address checks out
1639 N 1590th RdStreator, IL 61364-9644 Not confirmed with CMS for 13 years — call before visiting
Phone: (815) 793-6611
Fax: (630) 592-7500
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Adult Medicine Physician (primary) | Taxonomy 207QA0505X · Licence 036099987 (IL) |
|---|
Record details
| NPI number | 1730425851 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Mark Wargo — Physician · (815) 793-6611 |
| NPI enumerated | December 18, 2012 |
| Last updated in NPPES | December 18, 2012 |
| Mailing address | 1639 N 1590th Rd, Streator, IL 61364-9644 |