The Little Clinic Illinois

NPI 1063461887 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1063461887
Enumeration Date 05/09/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name MARY CAY MARY
Position OWNER
Phone (618) 246-9969
Fax
Practice Location
415 S 42ND ST
MOUNT VERNON IL, 62864-6266, US
Phone (618) 246-9969
Fax
Business Location
415 S 42ND ST
MOUNT VERNON IL, 62864-6266, US
Phone (618) 246-9969
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State
License Number
Remove 1063461887 NPI Number
 

According to our database, The Little Clinic Illinois NPI is 1063461887, taxonomy code is 363LF0000X The Little Clinic Illinois physically located at 415 S 42nd St, Mount Vernon IL, 62864-6266. NPI Number 1033115704 has the healthcare provider type.

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1063461887 NPI number is provided on an as is basis without warranty of any kind. 1063461887 is maintained by the National Plan & Provider Enumeration System. The contents of The Little Clinic Illinois are for informational purposes only.