New Leaf Primary Care | |
423 N High St Belleville IL 62220-1214 | |
(618) 806-7939 | |
(877) 295-7244 |
Full Name | New Leaf Primary Care |
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Speciality | Clinic/Center |
Location | 423 N High St, Belleville, Illinois |
Authorized Official Name and Position | Crystal Stone (CEO) |
Authorized Official Contact | 6184167738 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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New Leaf Primary Care 423 N High St Belleville IL 62220-1214 Ph: (618) 416-7738 | New Leaf Primary Care 423 N High St Belleville IL 62220-1214 Ph: (618) 806-7939 |
NPI Number | 1619409075 |
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Provider Enumeration Date | 04/03/2017 |
Last Update Date | 07/28/2023 |
Medicare PECOS PAC ID | 0547546194 |
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Medicare Enrollment ID | O20170413000897 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619409075 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Crystal Lynn Stone |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1518328624 PECOS PAC ID: 3476851221 Enrollment ID: I20160428000047 |
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