| Crossroads Family Medicine of Salem | |
|
1325 W Whittaker St Suite 3 Salem IL 62881-2007 | |
| (618) 548-4911 | |
| (618) 548-8052 |
| Full Name | Crossroads Family Medicine of Salem |
|---|---|
| Speciality | Family Medicine |
| Location | 1325 W Whittaker St, Salem, Illinois |
| Authorized Official Name and Position | Debbie T Brewer (DIRECTOR OF PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Family Medicine of Salem 1325 W Whittaker St Suite 3 Salem IL 62881-2007 Ph: (618) 548-4911 | Crossroads Family Medicine of Salem 1325 W Whittaker St Suite 3 Salem IL 62881-2007 Ph: (618) 548-4911 |
| NPI Number | 1598759516 |
|---|---|
| Provider Enumeration Date | 09/06/2005 |
| Last Update Date | 09/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598759516 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
| 363L00000X | Nurse Practitioner | (Illinois) | Secondary |
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