| Deatrice L Kellogg MD | |
|
2661 N Illinois St Pmb 309 Swansea IL 62226-2316 | |
| (618) 257-2029 | |
| (618) 235-5371 |
| Full Name | Deatrice L Kellogg MD |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 2661 N Illinois St, Swansea, Illinois |
| Authorized Official Name and Position | Deatrice Lumae Kellogg (OWNER) |
| Authorized Official Contact | 6182572029 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Deatrice L Kellogg MD 2661 N Illinois St Pmb 309 Swansea IL 62226-2316 Ph: (618) 257-2029 | Deatrice L Kellogg MD 2661 N Illinois St Pmb 309 Swansea IL 62226-2316 Ph: (618) 257-2029 |
| NPI Number | 1023058484 |
|---|---|
| Provider Enumeration Date | 06/07/2006 |
| Last Update Date | 09/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023058484 | NPI | - | NPPES |
| DE5033 | Other | RR MEDICARE | |
| 493905552 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 036097679 (Illinois) | Primary |
Figure 8 Integrative Health & Wellness LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Park Pl Ste C, Swansea, IL 62226 Phone: 732-425-4363 Fax: 618-257-0715 |
Master Medical Care LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Emerald Ter, Swansea, IL 62226 Phone: 618-235-6780 Fax: 618-235-6740 |
Adult Internal Medicine Practice LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15 Park Pl, Swansea, IL 62226 Phone: 618-257-0780 Fax: 618-257-0715 |
Alpha Performance Medicine S.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13 Wolf Creek Dr Ste 4, Swansea, IL 62226 Phone: 618-702-5742 |
Fairview Medical Group LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4972 Benchmark Centre Dr Ste 400, Swansea, IL 62226 Phone: 618-632-3343 Fax: 618-206-6281 |
Adult Internal Medicine Office Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 15 Park Pl Ste 1, Swansea, IL 62226 Phone: 618-580-1359 Fax: 618-234-7242 |