Granite City Psychiatry Llc

NPI 1013269984 - Clinic/Center - 261QM0801X

NPI Details
NPI 1013269984
Enumeration Date 10/02/2012
Last Updated 10/02/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name KARL KARL
Position MEMBER
Phone (618) 876-0653
Fax
Practice Location
2120 MADISON AVE
SUITE 405
GRANITE CITY IL, 62040-4744, US
Phone (618) 876-0653
Fax
Business Location
2120 MADISON AVE
SUITE 405
GRANITE CITY IL, 62040-4744, US
Phone
Fax
Toxanomy
Taxonomy Code 261QM0801X
License State Illinois
License Number 036105102
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According to our database, Granite City Psychiatry Llc NPI is 1013269984, taxonomy code is 261QM0801X and license number is 036105102, license state is located at Illinois. Granite City Psychiatry Llc physically located at 2120 Madison Ave, Granite City IL, 62040-4744. NPI Number 1033115704 has the healthcare provider type.

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1013269984 NPI number is provided on an as is basis without warranty of any kind. 1013269984 is maintained by the National Plan & Provider Enumeration System. The contents of Granite City Psychiatry Llc are for informational purposes only.