State Street Center - Medicare Primary Care in East Saint Louis, IL

State Street Center is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in East Saint Louis, Illinois. The current practice location for State Street Center is 2001 State St, East Saint Louis, Illinois. For appointments, you can reach them via phone at (618) 271-9191. The mailing address for State Street Center is 8080 State St, East Saint Louis, Illinois and phone number is (618) 397-3303.

State Street Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1811054935. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (618) 271-9191.

Contact Information

State Street Center
2001 State St
East Saint Louis
IL 62205-1803
(618) 271-9191
(618) 271-9617

Map and Direction


Primary Care Clinic Profile

Full NameState Street Center
SpecialityClinic/Center
Location2001 State St, East Saint Louis, Illinois
Authorized Official Name and PositionLarry Mcculley (CHIEF OPERATING OFFICER)
Authorized Official Contact6183320783
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
State Street Center
8080 State St
East Saint Louis
IL 62203-1808

Ph: (618) 397-3303
State Street Center
2001 State St
East Saint Louis
IL 62205-1803

Ph: (618) 271-9191

NPI Details:

NPI Number1811054935
Provider Enumeration Date01/02/2007
Last Update Date10/30/2008

Medicare PECOS Information:

Medicare PECOS PAC ID1456256874
Medicare Enrollment IDO20081029000867

Medical Identifiers

Medical identifiers for State Street Center such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1811054935NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Secondary
207V00000XObstetrics & Gynecology (* (Not Available))Secondary
208000000XPediatrics (* (Not Available))Secondary
261QF0400XClinic/center - Federally Qualified Health Center (fqhc) (* (Not Available))Primary
363L00000XNurse Practitioner (* (Not Available))Secondary

Reviews and Comments


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Phone: 618-482-7044    Fax: 618-482-7018

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.