| Staunton Clinic, Llc | |
|
444 N Edwardsville St Staunton IL 62088-1334 | |
| (618) 635-3800 | |
| (618) 635-3952 |
| Full Name | Staunton Clinic, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 444 N Edwardsville St, Staunton, Illinois |
| Authorized Official Name and Position | Diane L Dobrino (PRACTICE MANAGER) |
| Authorized Official Contact | 6186353800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Staunton Clinic, Llc 444 N Edwardsville St Staunton IL 62088-1334 Ph: (618) 635-3800 | Staunton Clinic, Llc 444 N Edwardsville St Staunton IL 62088-1334 Ph: (618) 635-3800 |
| NPI Number | 1598866386 |
|---|---|
| Provider Enumeration Date | 09/26/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1557305943 |
|---|---|
| Medicare Enrollment ID | O20050616000420 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598866386 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 001 (Illinois) | Primary |
| Provider Name | Rajneesh S Jain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932202595 PECOS PAC ID: 0345284733 Enrollment ID: I20050617000099 |
| Provider Name | Manish Mathur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598848194 PECOS PAC ID: 3971547365 Enrollment ID: I20050617000117 |
| Provider Name | Bryan Charles Siegfried |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366453466 PECOS PAC ID: 7517901903 Enrollment ID: I20050617000139 |
| Provider Name | Mara Knoche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245693068 PECOS PAC ID: 7618257403 Enrollment ID: I20161214000432 |
Community Hospital Of Staunton Specialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 402 N Wood St, Staunton, IL 62088 Phone: 618-635-4231 Fax: 618-635-4216 |