Department of Veterans Affairs

NPI #1538398656 in Decatur, Illinois

Provider Information

NPI Number: 1538398656
Entity Type: Organization
Organization Name: Department of Veterans Affairs
Primary Specialty: Clinic/Center - VA
Enumeration Date: Jul 10, 2009
Last Updated: Jul 10, 2009

Practice Location

Address: 3035 E MOUND RD
City: Decatur
State: Illinois
ZIP Code: 62526-9650
Phone: (217) 875-2670

Authorized Official

Name: DEBBIE TABELS
Title: CREDENTIALING & PRIVILEGING
Phone: (217) 554-5383

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - VA — VA	261QV0200X	Primary

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