| The Carbondale Clinic | |
|
2601 W Main St Carbondale IL 62901-1031 | |
| (618) 457-5200 | |
| (618) 549-5128 |
| Full Name | The Carbondale Clinic |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 2601 W Main St, Carbondale, Illinois |
| Authorized Official Name and Position | Allan Norman (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6184575200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Carbondale Clinic 2601 W Main St Carbondale IL 62901-1031 Ph: (618) 457-5200 | The Carbondale Clinic 2601 W Main St Carbondale IL 62901-1031 Ph: (618) 457-5200 |
| NPI Number | 1043378565 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 05/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043378565 | NPI | - | NPPES |
| 3910515 | Other | IL | BCBS |
| 690006448 | Other | IL | RAILROAD MEDICARE |
| 614350 | Other | IL | LEGACY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | 042-000266 (Illinois) | Primary |
Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 374 East Grand Avenue, Mail Code 674d, Carbondale, IL 62901 Phone: 618-453-3311 Fax: 618-453-4449 | |
Community Health & Emergency Services, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 Cedar Ct, Carbondale, IL 62901 Phone: 618-351-1213 Fax: 618-351-1905 | |
Southern Illinois Gi Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1100 W Diann Ln, Carbondale, IL 62901 Phone: 618-549-8006 Fax: 618-549-8434 | |
Carbondale Community High Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Giant City Rd, Carbondale, IL 62902 Phone: 618-457-4722 Fax: 618-457-3353 | |
Southern Illinois Medical Services, Nfp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-549-5361 Fax: 618-351-4878 | |
Brown's Family Medicine Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 207 W Jackson St, Carbondale, IL 62901 Phone: 618-351-9559 |