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100 N 8th St Suite 124 East Saint Louis IL 62201-2989 | |
(618) 397-3303 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 100 N 8th St, East Saint Louis, Illinois |
Authorized Official Name and Position | Larry Mcculley (CEO) |
Authorized Official Contact | 6183320783 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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8080 State St East Saint Louis IL 62203-1808 Ph: (618) 332-0953 | 100 N 8th St Suite 124 East Saint Louis IL 62201-2989 Ph: (618) 397-3303 |
NPI Number | 1770851875 |
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Provider Enumeration Date | 12/05/2011 |
Last Update Date | 12/05/2011 |
Identifier | Type | State | Issuer |
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1770851875 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Osh-il Physicians Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2420 State St, East Saint Louis, IL 62205 Phone: 618-318-8809 Fax: 618-615-4205 | |
Southern Illinois Regional Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1736 Kingshighway, East Saint Louis, IL 62204 Phone: 618-874-3120 Fax: 618-215-4048 | |
Kenneth Hall Regional Hospital, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 129 N 8th St, East Saint Louis, IL 62201 Phone: 618-482-7044 Fax: 618-482-7018 |