| |
300 W Oak St Ste 100 Carbondale IL 62901-1496 | |
(618) 453-3777 | |
(618) 453-1102 |
Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 300 W Oak St Ste 100, Carbondale, Illinois |
Authorized Official Name and Position | Iris Wesley (C.E.O.) |
Authorized Official Contact | 2175458137 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
201 E Madison St Ste 328 Springfield IL 62702-5131 Ph: (217) 545-6523 | 300 W Oak St Ste 100 Carbondale IL 62901-1496 Ph: (618) 453-3777 |
NPI Number | 1215978127 |
---|---|
Provider Enumeration Date | 06/10/2006 |
Last Update Date | 05/03/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215978127 | NPI | - | NPPES |
CE8688 | Other | IL | RR MEDICARE |
CE8687 | Other | IL | RR MEDICARE |
CE8689 | Other | IL | RR MEDICARE |
CE8931 | Other | IL | RR MEDICARE |
CB2589 | Other | IL | RR HEALTH |
CE8686 | Other | IL | RR MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
The Carbondale Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-457-5200 Fax: 618-549-5128 | |
Southern Illinois Gi Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1100 W Diann Ln, Carbondale, IL 62901 Phone: 618-549-8006 Fax: 618-549-8434 | |
Carbondale Community High Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Giant City Rd, Carbondale, IL 62902 Phone: 618-457-4722 Fax: 618-457-3353 | |
Brown's Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 W Jackson St, Carbondale, IL 62901 Phone: 618-351-9559 |