| Southern Illinois Gastroenterology Llc | |
|
1212 Broadway Highland IL 62249-1960 | |
| (618) 391-5070 | |
| (618) 288-1872 |
| Full Name | Southern Illinois Gastroenterology Llc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1212 Broadway, Highland, Illinois |
| Authorized Official Name and Position | Edmundo A Rodriguez-frias (OWNER) |
| Authorized Official Contact | 6183915070 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Gastroenterology Llc 1212 Broadway Highland IL 62249-1960 Ph: (618) 391-5070 | Southern Illinois Gastroenterology Llc 1212 Broadway Highland IL 62249-1960 Ph: (618) 391-5070 |
| NPI Number | 1902467798 |
|---|---|
| Provider Enumeration Date | 06/24/2019 |
| Last Update Date | 06/24/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902467798 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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