| Community Healthcare Clinic | |
|
905 W Washington St Benton IL 62812-1649 | |
| (618) 435-5444 | |
| Not Available |
| Full Name | Community Healthcare Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 905 W Washington St, Benton, Illinois |
| Authorized Official Name and Position | David Frank Szoke (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6184355444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Healthcare Clinic 905 W Washington St Benton IL 62812-1649 Ph: (618) 435-5444 | Community Healthcare Clinic 905 W Washington St Benton IL 62812-1649 Ph: (618) 435-5444 |
| NPI Number | 1811385347 |
|---|---|
| Provider Enumeration Date | 01/06/2015 |
| Last Update Date | 03/30/2015 |
| Medicare PECOS PAC ID | 8325366222 |
|---|---|
| Medicare Enrollment ID | O20150403000890 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811385347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 036085242 (Illinois) | Primary |
| Provider Name | David F Szoke |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1477531192 PECOS PAC ID: 2062471121 Enrollment ID: I20041005001164 |
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