| Primary Care Group | |
|
117 E Clark St Harrisburg IL 62946-2702 | |
| (618) 252-8625 | |
| (618) 252-2540 |
| Full Name | Primary Care Group |
|---|---|
| Speciality | Family Medicine |
| Location | 117 E Clark St, Harrisburg, Illinois |
| Authorized Official Name and Position | Michelle Boatright (ADMINISTRATOR) |
| Authorized Official Contact | 6182528625 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Group 117 E Clark St Harrisburg IL 62946-2702 Ph: (618) 252-8625 | Primary Care Group 117 E Clark St Harrisburg IL 62946-2702 Ph: (618) 252-8625 |
| NPI Number | 1265419261 |
|---|---|
| Provider Enumeration Date | 12/30/2005 |
| Last Update Date | 09/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265419261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036042756 (Illinois) | Primary |
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Primary Care Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540 |