| Kaskaskia Medical Center, Ltd | |
|
1003 N 8th St Vandalia IL 62471-1238 | |
| (618) 283-4445 | |
| (618) 283-4446 |
| Full Name | Kaskaskia Medical Center, Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 1003 N 8th St, Vandalia, Illinois |
| Authorized Official Name and Position | Michael Darmadi (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6182834445 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaskaskia Medical Center, Ltd 1003 N 8th St Vandalia IL 62471-1238 Ph: (618) 283-4445 | Kaskaskia Medical Center, Ltd 1003 N 8th St Vandalia IL 62471-1238 Ph: (618) 283-4445 |
| NPI Number | 1508844325 |
|---|---|
| Provider Enumeration Date | 01/03/2006 |
| Last Update Date | 03/26/2018 |
| Medicare PECOS PAC ID | 4587735022 |
|---|---|
| Medicare Enrollment ID | O20080611000365 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508844325 | NPI | - | NPPES |
| 036097600 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036097600 (Illinois) | Primary |
| 208000000X | Pediatrics | 036097600 (Illinois) | Secondary |
| Provider Name | Michael H Darmadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184601577 PECOS PAC ID: 1951472489 Enrollment ID: I20080611000358 |
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