| Vicente S. Zata, M.d.,p.c. | |
|
2 Myrtle Lane Hardin IL 62047-0310 | |
| (618) 576-2416 | |
| (618) 576-9298 |
| Full Name | Vicente S. Zata, M.d.,p.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2 Myrtle Lane, Hardin, Illinois |
| Authorized Official Name and Position | Janeth Concepcion Jacinto-zata (PHYSICIAN PCP) |
| Authorized Official Contact | 6185762416 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vicente S. Zata, M.d.,p.c. 2 Myrtle Lane P.o Box 310 Hardin IL 62047-0310 Ph: (618) 576-2416 | Vicente S. Zata, M.d.,p.c. 2 Myrtle Lane Hardin IL 62047-0310 Ph: (618) 576-2416 |
| NPI Number | 1306933262 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 10/09/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306933262 | NPI | - | NPPES |
| 0000715000 | Other | IL | BCBS |
| 036051832 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036-051832 (Illinois) | Primary |
Jersey Community Hospital Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2 Myrtle Lane, Hardin, IL 62047 Phone: 618-576-9407 Fax: 618-576-2260 |