|
| |
|
100 E 12th St Johnston City IL 62951-1513 | |
| (618) 519-9200 | |
| (618) 998-0880 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 100 E 12th St, Johnston City, Illinois |
| Authorized Official Name and Position | Christina Carney (CEO) |
| Authorized Official Contact | 6189569521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
109 California St Po Box 577 Carterville IL 62918 Ph: (618) 519-9200 | 100 E 12th St Johnston City IL 62951-1513 Ph: (618) 519-9200 |
| NPI Number | 1083328843 |
|---|---|
| Provider Enumeration Date | 01/06/2023 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083328843 | NPI | - | NPPES |
Chrysalis Behavior Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13887 Jeffrey Mine Road, Johnston City, IL 62951 Phone: 618-521-7177 Fax: 314-667-3167 | |
Nova M. Griffith, Ph.d., Psychological Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 E Broadway Blvd, Johnston City, IL 62951 Phone: 618-969-2922 | |