| Sth Family Health Care Center | |
|
1321 W Whittaker St Salem IL 62881-2013 | |
| (618) 548-6644 | |
| (844) 659-5619 |
| Full Name | Sth Family Health Care Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1321 W Whittaker St, Salem, Illinois |
| Authorized Official Name and Position | James Timpe (PRESIDENT/CEO/CFO) |
| Authorized Official Contact | 6185483194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sth Family Health Care Center 1201 Ricker Rd Salem IL 62881-4263 Ph: (618) 548-3194 | Sth Family Health Care Center 1321 W Whittaker St Salem IL 62881-2013 Ph: (618) 548-6644 |
| NPI Number | 1649830472 |
|---|---|
| Provider Enumeration Date | 06/14/2019 |
| Last Update Date | 08/01/2024 |
| Medicare PECOS PAC ID | 0840195277 |
|---|---|
| Medicare Enrollment ID | O20190702001978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649830472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Margaret Chelsea Ann Burris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093395022 PECOS PAC ID: 1850770215 Enrollment ID: I20220615002712 |
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