| Desoto Ccsd 86 | |
|
311 Hurst Rd De Soto IL 62924-1228 | |
| (618) 867-2317 | |
| (618) 867-3233 |
| Full Name | Desoto Ccsd 86 |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 311 Hurst Rd, De Soto, Illinois |
| Authorized Official Name and Position | Mark E Bullock (SUPERINTENDENT) |
| Authorized Official Contact | 6188672317 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Desoto Ccsd 86 311 Hurst Rd De Soto IL 62924-1228 Ph: (618) 867-2317 | Desoto Ccsd 86 311 Hurst Rd De Soto IL 62924-1228 Ph: (618) 867-2317 |
| NPI Number | 1700904216 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 04/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700904216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (Illinois) | Primary |
Desoto Family Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 407 S Chestnut St, De Soto, IL 62924 Phone: 618-867-2703 Fax: 618-867-2353 | |
Desoto Cons School Districxt 86 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 311 Hurst Rd, De Soto, IL 62924 Phone: 618-867-2317 Fax: 618-867-3233 |