Mclean County Neurology Sc
NPI #1760431712 in Bloomington, Illinois
Provider Information
- NPI Number
- 1760431712
- Entity Type
- Organization
- Organization Name
- Mclean County Neurology Sc
- Primary Specialty
- Psychiatry & Neurology - Neurology
- Enumeration Date
- May 8, 2006
- Last Updated
- Jun 5, 2008
Practice Location
- Address
- 2204 EASTLAND DR
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-3566
- Phone
- (309) 662-9461
Authorized Official
- Name
- DR. HERMAN JUSTUS DICK JR., MD
- Title
- MANAGING PARTNER
- Phone
- (309) 662-9461
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Neurology — Neurology |
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