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Dr.kenbroshddspc
Point of Service in Mascoutah, Illinois
NPI 1134399421

Dr.kenbroshddspc is a Point of Service based in Mascoutah, IL. Dr.kenbroshddspc practices in Mascoutah, IL. The NPI Number for Dr.kenbroshddspc is 1134399421 and holds a License No. 019019341 (Illinois).

The current practice location address for Dr.kenbroshddspc is 1180 N 6Th St, Mascoutah, IL and can be reached out via phone at 618-566-7000 and via fax at 618-566-7000.

Location: 1180 N 6Th St, Mascoutah, IL, 62258-1178
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1134399421
Provider Name
Dr.kenbroshddspc
Credential
Provider Entity Type
Organization
Address
1180 N 6Th St, Mascoutah, IL, 62258-1178
Phone Number
618-566-7000
Fax Number
618-566-7000
Provider Enumeration Date
03/03/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1180 N 6Th St
City
Mascoutah
State
Illinois
Zip
62258-1178
Phone Number
618-566-7000
Fax Number
618-566-7000
person
Provider Business Mailing Address Details
Address
1180 N 6Th St
City
Mascoutah
State
Illinois
Zip
62258-1178
Phone Number
618-566-7000
Fax Number
618-566-7000
person
Provider's Taxonomy Details 1
Type
Managed Care Organizations
Classification
Point of Service
Speciality
-
Taxonomy
305S00000X
License No.
019019341 (Illinois)
Definition
This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
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