The Carbondale Clinic | |
2601 W Main St Carbondale IL 62901-1031 | |
(618) 457-5200 | |
(618) 549-5128 |
Full Name | The Carbondale Clinic |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 2601 W Main St, Carbondale, Illinois |
Authorized Official Name and Position | Allan Norman (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6184575200 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
The Carbondale Clinic 2601 W Main St Carbondale IL 62901-1031 Ph: (618) 457-5200 | The Carbondale Clinic 2601 W Main St Carbondale IL 62901-1031 Ph: (618) 457-5200 |
NPI Number | 1043378565 |
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Provider Enumeration Date | 12/05/2006 |
Last Update Date | 05/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043378565 | NPI | - | NPPES |
3910515 | Other | IL | BCBS |
690006448 | Other | IL | RAILROAD MEDICARE |
614350 | Other | IL | LEGACY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | 042-000266 (Illinois) | Primary |
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 |