| Carbondale Family Medicine,llc | |
|
1175 Cedar Ct Carbondale IL 62901-5333 | |
| (618) 549-0300 | |
| Not Available |
| Full Name | Carbondale Family Medicine,llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1175 Cedar Ct, Carbondale, Illinois |
| Authorized Official Name and Position | Mukesh Chaudhry (MD) |
| Authorized Official Contact | 6185490300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carbondale Family Medicine,llc 190 High Forest Dr Carbondale IL 62903-8245 Ph: (618) 549-0300 | Carbondale Family Medicine,llc 1175 Cedar Ct Carbondale IL 62901-5333 Ph: (618) 549-0300 |
| NPI Number | 1518023530 |
|---|---|
| Provider Enumeration Date | 12/28/2006 |
| Last Update Date | 01/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518023530 | NPI | - | NPPES |
| 036-107111 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-107111 (Illinois) | Primary |
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