| Southern Illinois Regional Wellness Center | |
|
1835 Kingshighway Washington Park IL 62204-2135 | |
| (618) 482-7922 | |
| (618) 482-7881 |
| Full Name | Southern Illinois Regional Wellness Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1835 Kingshighway, Washington Park, Illinois |
| Authorized Official Name and Position | Mark R Freeland (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6188743120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Illinois Regional Wellness Center 1835 Kingshighway Washington Park IL 62204-2135 Ph: (618) 482-7922 | Southern Illinois Regional Wellness Center 1835 Kingshighway Washington Park IL 62204-2135 Ph: (618) 482-7922 |
| NPI Number | 1265588776 |
|---|---|
| Provider Enumeration Date | 01/26/2007 |
| Last Update Date | 12/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265588776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Southern Il Regional Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1736 Kingshighway, Washington Park, IL 62204 Phone: 618-482-7922 Fax: 618-215-4048 |