The Carbondale Clinic

NPI 1043378565 - Clinic/Center - 261QM1300X

NPI Details
NPI 1043378565
Enumeration Date 12/05/2006
Last Updated 05/08/2008
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name ALLAN ALLAN
Position CHIEF EXECUTIVE OFFICER
Phone (618) 457-5200
Fax (618) 549-5128
Practice Location
2601 W MAIN ST
CARBONDALE IL, 62901-1031, US
Phone (618) 457-5200
Fax (618) 549-5128
Business Location
2601 W MAIN ST
CARBONDALE IL, 62901-1031, US
Phone (618) 457-5200
Fax (618) 457-4542
Toxanomy
Taxonomy Code 261QM1300X
License State Illinois
License Number 042-000266
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According to our database, The Carbondale Clinic NPI is 1043378565, taxonomy code is 261QM1300X and license number is 042-000266, license state is located at Illinois. The Carbondale Clinic physically located at 2601 W Main St, Carbondale IL, 62901-1031. NPI Number 1033115704 has the healthcare provider type.

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1043378565 NPI number is provided on an as is basis without warranty of any kind. 1043378565 is maintained by the National Plan & Provider Enumeration System. The contents of The Carbondale Clinic are for informational purposes only.