Full Name | |
---|---|
Speciality | Clinic/center - Student Health |
Location | 309 Cook Ave, Jonesboro, Illinois |
Authorized Official Name and Position | Gary Hill (SUPERINTENDENT) |
Authorized Official Contact | 6188336651 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
309 Cook Ave Jonesboro IL 62952 Ph: (618) 833-6651 | 309 Cook Ave Jonesboro IL 62952 Ph: (618) 833-6651 |
NPI Number | 1619094364 |
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Provider Enumeration Date | 03/26/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619094364 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QS1000X | Clinic/center - Student Health | (Illinois) | Primary |