| Illini Family Medicine | |
|
2900 Frank Scott Pkwy W Suite 980 Belleville IL 62223-5000 | |
| (618) 397-3303 | |
| Not Available |
| Full Name | Illini Family Medicine |
|---|---|
| Speciality | Clinic/Center |
| Location | 2900 Frank Scott Pkwy W, Belleville, Illinois |
| Authorized Official Name and Position | Larry Mcculley (CEO) |
| Authorized Official Contact | 6183320694 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illini Family Medicine 2041 Goose Lake Rd Sauget IL 62206-2822 Ph: (618) 332-0953 | Illini Family Medicine 2900 Frank Scott Pkwy W Suite 980 Belleville IL 62223-5000 Ph: (618) 397-3303 |
| NPI Number | 1255880647 |
|---|---|
| Provider Enumeration Date | 09/26/2016 |
| Last Update Date | 09/26/2016 |
| Medicare PECOS PAC ID | 1456256874 |
|---|---|
| Medicare Enrollment ID | O20161018001776 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255880647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Illinois) | Primary |
Pc Associate, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Ste 160, Belleville, IL 62226 Phone: 618-235-0460 Fax: 618-235-1464 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-233-7750 | |
Pc Associates ,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Drive, Ste. 220, Belleville, IL 62226 Phone: 618-235-6191 Fax: 618-235-6716 | |
Healthcare Physicians Of Southern Illinois, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Suite 100, Belleville, IL 62226 Phone: 618-222-9999 Fax: 618-222-9337 | |
Pc Associate, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr Ste 400, Belleville, IL 62226 Phone: 618-235-0460 Fax: 618-235-1464 | |
Albarcha Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-233-7750 Fax: 618-355-9972 | |
Cep America - Illinois Snf, Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 150 N 27th St, Belleville, IL 62226 Phone: 618-235-6600 |