| Gcp Aco Illinois | |
|
623 Hamacher St Waterloo IL 62298-1786 | |
| (314) 925-0903 | |
| Not Available |
| Full Name | Gcp Aco Illinois |
|---|---|
| Speciality | Internal Medicine |
| Location | 623 Hamacher St, Waterloo, Illinois |
| Authorized Official Name and Position | Rebecca Mueller (OFFICE MANAGER) |
| Authorized Official Contact | 3149250903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gcp Aco Illinois 10426 Baur Blvd Saint Louis MO 63132-1905 Ph: (314) 925-0903 | Gcp Aco Illinois 623 Hamacher St Waterloo IL 62298-1786 Ph: (314) 925-0903 |
| NPI Number | 1104674431 |
|---|---|
| Provider Enumeration Date | 05/10/2024 |
| Last Update Date | 05/10/2024 |
| Certification Date | 05/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104674431 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
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