| Jackson Street Family Practice Center, Ltd | |
|
3331 W Deyoung St Suite 207 Marion IL 62959-5896 | |
| (618) 998-7000 | |
| Not Available |
| Full Name | Jackson Street Family Practice Center, Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 3331 W Deyoung St, Marion, Illinois |
| Authorized Official Name and Position | Karen Strack (OFFICER) |
| Authorized Official Contact | 6189987000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jackson Street Family Practice Center, Ltd Po Box 446 Murphysboro IL 62966-0446 Ph: (618) 924-5149 | Jackson Street Family Practice Center, Ltd 3331 W Deyoung St Suite 207 Marion IL 62959-5896 Ph: (618) 998-7000 |
| NPI Number | 1356355259 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356355259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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