Contract Details
Facility name
McHenry Medical Center
Provider ID
P000004361
NPI
1366585291
Tax ID
364388265
Effective Date
4/1/2012
Last Updated
10/23/2012
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
84.00
Location Details
Address
4801 West Elm St
McHenry, IL 60050
United States
County
McHenry
Phone
8153441192 (Phone)
Billing Details
Address
5429 LBJ Freeway
Suite 700
Dallas, TX 75240
Specialty Type
Chiropractic Medicine
Map
Address