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401 E Park St Benton IL 62812-1920 | |
(618) 435-2505 | |
(618) 438-6015 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 401 E Park St, Benton, Illinois |
Authorized Official Name and Position | Cathy D Lisenby (OFFICE MANAGER) |
Authorized Official Contact | 6184352505 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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401 E Park St Benton IL 62812-1920 Ph: (618) 435-2505 | 401 E Park St Benton IL 62812-1920 Ph: (618) 435-2505 |
NPI Number | 1841405610 |
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Provider Enumeration Date | 05/14/2007 |
Last Update Date | 04/20/2008 |
Identifier | Type | State | Issuer |
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1841405610 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Illinois) | Primary |
Christopher Greater Area Rural Health Planning Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 206 E Church St, Benton, IL 62812 Phone: 618-435-9888 Fax: 618-435-9889 | |
Christopher Greater Area Rural Health Planning Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 107 E Smith St Ste B, Benton, IL 62812 Phone: 618-435-9315 Fax: 618-435-9316 | |