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3111 Williamson County Parkway Marion IL 62959-5209 | |
(618) 997-5270 | |
(618) 985-9155 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3111 Williamson County Parkway, Marion, Illinois |
Authorized Official Name and Position | Christina Carney (CEO) |
Authorized Official Contact | 6189569521 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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109 California P O Box 577 Carterville IL 62918-0577 Ph: (618) 985-8221 | 3111 Williamson County Parkway Marion IL 62959-5209 Ph: (618) 997-5270 |
NPI Number | 1649405150 |
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Provider Enumeration Date | 05/28/2009 |
Last Update Date | 08/05/2024 |
Certification Date | 08/05/2024 |
Medicare PECOS PAC ID | 1658285671 |
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Medicare Enrollment ID | O20090916000489 |
Identifier | Type | State | Issuer |
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1649405150 | NPI | - | NPPES |
CF3444 | Other | IL | MEDICARE RAIL ROAD |
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