Full Name | |
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Speciality | Family Medicine |
Location | 515 N Main St, Anna, Illinois |
Authorized Official Name and Position | Kyle Dillman (SECRETARY / TREASURER) |
Authorized Official Contact | 8124507399 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 34156 Belfast ME 04915-0619 Ph: (812) 450-6815 | 515 N Main St Anna IL 62906-1668 Ph: (618) 833-4511 |
NPI Number | 1366169997 |
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Provider Enumeration Date | 10/25/2022 |
Last Update Date | 12/02/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366169997 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208600000X | Surgery | (* (Not Available)) | Secondary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
Hunter Reach Family Medicine, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 98 Peach Ridge Road, Anna, IL 62906 Phone: 618-614-1400 Fax: 618-614-1401 | |