Eldermed Services | |
1512 N Green Mount Rd Suite 200 O Fallon IL 62269-1953 | |
(618) 234-2120 | |
(618) 222-4703 |
Full Name | Eldermed Services |
---|---|
Speciality | Clinic/center |
Location | 1512 N Green Mount Rd, O Fallon, Illinois |
Authorized Official Name and Position | Mark D Evard (VP OF REVENUE CYCLE) |
Authorized Official Contact | 2174929651 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Eldermed Services 3051 Hollis Dr Springfield IL 62704-7450 Ph: (618) 234-2120 | Eldermed Services 1512 N Green Mount Rd Suite 200 O Fallon IL 62269-1953 Ph: (618) 234-2120 |
NPI Number | 1003091570 |
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Provider Enumeration Date | 01/03/2008 |
Last Update Date | 10/31/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003091570 | NPI | - | NPPES |
036115149 | Other | IL | INTERNAL MEDICINE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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