| Hshs Medical Group Family Medicine - Dieterich | |
|
207 S Main St Dieterich IL 62424-1128 | |
| (217) 925-5730 | |
| Not Available |
| Full Name | Hshs Medical Group Family Medicine - Dieterich |
|---|---|
| Speciality | Clinic/Center |
| Location | 207 S Main St, Dieterich, Illinois |
| Authorized Official Name and Position | Kevin Lewis (CHIEF CLINICAL OFFICER) |
| Authorized Official Contact | 2175234747 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hshs Medical Group Family Medicine - Dieterich 3051 Hollis Dr Fl 2 Springfield IL 62704-7450 Ph: () - | Hshs Medical Group Family Medicine - Dieterich 207 S Main St Dieterich IL 62424-1128 Ph: (217) 925-5730 |
| NPI Number | 1033841192 |
|---|---|
| Provider Enumeration Date | 06/28/2022 |
| Last Update Date | 06/18/2024 |
| Medicare PECOS PAC ID | 5092857821 |
|---|---|
| Medicare Enrollment ID | O20220812001021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033841192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Dieterich Community Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 203 S. Main St., Dieterich, IL 62424 Phone: 217-925-5730 Fax: 217-925-5736 |