Provider Demographics
NPI:1346693074
Name:BAYVIEW FAMILY CLINIC
Entity type:Organization
Organization Name:BAYVIEW FAMILY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:RATTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-356-3400
Mailing Address - Street 1:206 BURWASH AVE
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:IL
Mailing Address - Zip Code:61874-9510
Mailing Address - Country:US
Mailing Address - Phone:217-356-3400
Mailing Address - Fax:
Practice Address - Street 1:206 BURWASH AVE
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:IL
Practice Address - Zip Code:61874-9510
Practice Address - Country:US
Practice Address - Phone:217-356-3400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty