| Chester Clinic Professional Corp | |
|
2319 Old Plank Rd Chester IL 62233 | |
| (618) 826-2388 | |
| (618) 826-3350 |
| Full Name | Chester Clinic Professional Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 2319 Old Plank Rd, Chester, Illinois |
| Authorized Official Name and Position | Donna M Martin (ADMINISTRATOR / CEO) |
| Authorized Official Contact | 6188262388 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chester Clinic Professional Corp 2319 Old Plank Rd Chester IL 62233 Ph: (618) 826-2388 | Chester Clinic Professional Corp 2319 Old Plank Rd Chester IL 62233 Ph: (618) 826-2388 |
| NPI Number | 1235117417 |
|---|---|
| Provider Enumeration Date | 01/06/2006 |
| Last Update Date | 06/07/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235117417 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | 060002310 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | (Illinois) | Primary |
Chester Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2319 Old Plank Rd, Chester, IL 62233 Phone: 618-826-2388 Fax: 618-826-3350 |