| Nationwide Medical Network | |
|
1333 Central Park Drive Suite 102 O Fallon IL 62269 | |
| (618) 477-4960 | |
| Not Available |
| Full Name | Nationwide Medical Network |
|---|---|
| Speciality | General Practice |
| Location | 1333 Central Park Drive Suite 102, O Fallon, Illinois |
| Authorized Official Name and Position | Racheal Hannah (MANAGING DIRECTOR) |
| Authorized Official Contact | 6184779640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nationwide Medical Network 4020 Green Mount Crossing Dr Ste 143 O Fallon IL 62269-7287 | Nationwide Medical Network 1333 Central Park Drive Suite 102 O Fallon IL 62269 Ph: (618) 477-4960 |
| NPI Number | 1578226569 |
|---|---|
| Provider Enumeration Date | 10/18/2021 |
| Last Update Date | 10/18/2021 |
| Certification Date | 09/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578226569 | NPI | - | NPPES |
| 10892503 | Other | IL | ARTICLES OF ORGANIZATION |
| 10892503 | Other | IL | ARTICLES OF ORANIZATION |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | () | Primary |
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