| Sirss | |
|
250 S Lewis Ln Carbondale IL 62901-3409 | |
| (618) 457-6703 | |
| (618) 457-8377 |
| Full Name | Sirss |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 250 S Lewis Ln, Carbondale, Illinois |
| Authorized Official Name and Position | Karen S Freitag (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6184576703 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sirss 604 E College St Carbondale IL 62901-3309 Ph: (618) 457-6703 | Sirss 250 S Lewis Ln Carbondale IL 62901-3409 Ph: (618) 457-6703 |
| NPI Number | 1205074630 |
|---|---|
| Provider Enumeration Date | 01/22/2009 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205074630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | A-0243-0001-A (Illinois) | Primary |
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