| Si Vitality Specialty Clinic Llc | |
|
209 W Commercial Dr Ste E Carterville IL 62918-2057 | |
| (618) 684-7087 | |
| (618) 822-4045 |
| Full Name | Si Vitality Specialty Clinic Llc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 209 W Commercial Dr Ste E, Carterville, Illinois |
| Authorized Official Name and Position | Samantha Christopher (APRN, FOUNDER) |
| Authorized Official Contact | 6186847087 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Si Vitality Specialty Clinic Llc 209 W Commercial Dr Ste E Carterville IL 62918-2057 Ph: (618) 684-7087 | Si Vitality Specialty Clinic Llc 209 W Commercial Dr Ste E Carterville IL 62918-2057 Ph: (618) 684-7087 |
| NPI Number | 1760286413 |
|---|---|
| Provider Enumeration Date | 04/02/2025 |
| Last Update Date | 04/02/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760286413 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Si Vitality Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 W Commercial Dr Ste E, Carterville, IL 62918 Phone: 618-684-7087 Fax: 618-822-4045 |