| Illinois Rural Healthcare | |
|
17781 Hornbean Dr Wildwood MO 63005-4229 | |
| (312) 953-5636 | |
| Not Available |
| Full Name | Illinois Rural Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | 17781 Hornbean Dr, Wildwood, Missouri |
| Authorized Official Name and Position | Sarfaraz Jasdanwala (CEO) |
| Authorized Official Contact | 0312953563 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Illinois Rural Healthcare 1003 Hauck Dr Rolla MO 65401-2584 Ph: (573) 466-2056 | Illinois Rural Healthcare 17781 Hornbean Dr Wildwood MO 63005-4229 Ph: (312) 953-5636 |
| NPI Number | 1093493041 |
|---|---|
| Provider Enumeration Date | 07/10/2023 |
| Last Update Date | 07/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093493041 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
Mercy Clinic Convenient Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 16555 Manchester Rd Ste 110, Wildwood, MO 63040 Phone: 636-405-3155 Fax: 636-405-3162 | |
Idim Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1909 Larimer Trl, Wildwood, MO 63011 Phone: 636-273-5311 | |
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Wildwood Internal Medicine, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16759 Main Street, Suite 203, Wildwood, MO 63040 Phone: 636-458-4800 Fax: 636-594-7500 |