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502 West St Louis Street West Frankfort Community Health Center West Frankfort IL 62896 | |
(618) 937-6409 | |
(618) 937-1619 |
Full Name | |
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Speciality | Family Medicine |
Location | 502 West St Louis Street, West Frankfort, Illinois |
Authorized Official Name and Position | Kim A Mitroka (PRESIDENT CEO) |
Authorized Official Contact | 6187242401 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 155 Rca Clinic Christopher IL 62822 Ph: (618) 924-2401 | 502 West St Louis Street West Frankfort Community Health Center West Frankfort IL 62896 Ph: (618) 937-6409 |
NPI Number | 1528266608 |
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Provider Enumeration Date | 07/10/2007 |
Last Update Date | 04/20/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528266608 | NPI | - | NPPES |
617270 | Other | IL | MEDICARE |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Logan Primary Care Service Corp. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 W St Louis, West Frankfort, IL 62896 Phone: 618-997-3400 Fax: 618-932-3797 | |