| Sunrise Family Practice Weight Loss And Pain Management | |
|
1706 Cloverdale Dr Edwardsville IL 62025-5500 | |
| (847) 852-0145 | |
| Not Available |
| Full Name | Sunrise Family Practice Weight Loss And Pain Management |
|---|---|
| Speciality | Clinic/Center |
| Location | 1706 Cloverdale Dr, Edwardsville, Illinois |
| Authorized Official Name and Position | Gerthy Cipus Pierre (FAMILY NURSE PRACTITIONER) |
| Authorized Official Contact | 8478520145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sunrise Family Practice Weight Loss And Pain Management 1706 Cloverdale Dr Edwardsville IL 62025-5500 Ph: (847) 852-0145 | Sunrise Family Practice Weight Loss And Pain Management 1706 Cloverdale Dr Edwardsville IL 62025-5500 Ph: (847) 852-0145 |
| NPI Number | 1821746421 |
|---|---|
| Provider Enumeration Date | 03/13/2022 |
| Last Update Date | 07/01/2024 |
| Medicare PECOS PAC ID | 4082091863 |
|---|---|
| Medicare Enrollment ID | O20220517001039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821746421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Gerthy Cipus Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083126353 PECOS PAC ID: 8224391495 Enrollment ID: I20220517001200 |
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