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1321 W Whittaker St Salem IL 62881-2013 | |
(618) 548-0200 | |
(618) 548-0924 |
Full Name | |
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Speciality | Family Medicine |
Location | 1321 W Whittaker St, Salem, Illinois |
Authorized Official Name and Position | Kendra K Taylor (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6185483194 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1201 Ricker Rd Salem IL 62881-4263 Ph: (618) 548-3194 | 1321 W Whittaker St Salem IL 62881-2013 Ph: (618) 548-0200 |
NPI Number | 1629433784 |
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Provider Enumeration Date | 12/16/2015 |
Last Update Date | 01/28/2020 |
Identifier | Type | State | Issuer |
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1629433784 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Anton Dubrick Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W Schwartz St, Salem, IL 62881 Phone: 618-740-4667 Fax: 618-740-1482 | |