| Brian J Shaheen MD SC | |
|
1104 S 42nd Street Mount Vernon IL 62864-6216 | |
| (618) 244-2296 | |
| (618) 244-0074 |
| Full Name | Brian J Shaheen MD SC |
|---|---|
| Speciality | Family Medicine |
| Location | 1104 S 42nd Street, Mount Vernon, Illinois |
| Authorized Official Name and Position | Brian J Shaheen (PRESIDENT) |
| Authorized Official Contact | 6182442296 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian J Shaheen MD SC 4227 Lincolshire Drive Mount Vernon IL 62864-2157 Ph: (618) 242-2317 | Brian J Shaheen MD SC 1104 S 42nd Street Mount Vernon IL 62864-6216 Ph: (618) 244-2296 |
| NPI Number | 1336214584 |
|---|---|
| Provider Enumeration Date | 11/22/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336214584 | NPI | - | NPPES |
| 704010 | Other | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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