| Cedar Court Clinic | |
|
1340 Cedar Ct Carbondale IL 62901-5336 | |
| (618) 457-7821 | |
| (618) 529-3862 |
| Full Name | Cedar Court Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1340 Cedar Ct, Carbondale, Illinois |
| Authorized Official Name and Position | Frederick L Bernstein (CEO) |
| Authorized Official Contact | 6184570450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cedar Court Clinic Po Box 3008 Carbondale IL 62902-3008 Ph: (618) 457-0450 | Cedar Court Clinic 1340 Cedar Ct Carbondale IL 62901-5336 Ph: (618) 457-7821 |
| NPI Number | 1316939929 |
|---|---|
| Provider Enumeration Date | 08/19/2005 |
| Last Update Date | 08/23/2022 |
| Medicare PECOS PAC ID | 0749194702 |
|---|---|
| Medicare Enrollment ID | O20070202000090 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316939929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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