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205 Bailey Ln Ste F Benton IL 62812-1921 | |
(618) 882-4200 | |
(618) 882-4208 |
Full Name | |
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Speciality | Family Medicine |
Location | 205 Bailey Ln Ste F, Benton, Illinois |
Authorized Official Name and Position | Kyle Dillman (SECRETARY) |
Authorized Official Contact | 8124507399 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 34156 Belfast ME 04915-0619 Ph: (812) 450-6815 | 205 Bailey Ln Ste F Benton IL 62812-1921 Ph: (618) 882-4200 |
NPI Number | 1790401081 |
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Provider Enumeration Date | 10/18/2022 |
Last Update Date | 01/26/2023 |
Identifier | Type | State | Issuer |
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1790401081 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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 | |