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Southern Illinois Consultants For Kidney Disease, S.c.
Specialist in Mount Vernon, Illinois
NPI 1144283300

Southern Illinois Consultants For Kidney Disease, S.c. is a Specialist based in Mount Vernon, IL. Southern Illinois Consultants For Kidney Disease, S.c. practices in Mount Vernon, IL. The NPI Number for Southern Illinois Consultants For Kidney Disease, S.c. is 1144283300 and holds a License No. 060-007470 (Illinois).

The current practice location address for Southern Illinois Consultants For Kidney Disease, S.c. is 416 N 12Th St, Mount Vernon, IL and can be reached out via phone at 618-244-4850 and via fax at 618-244-7985.

Location: 416 N 12Th St, Mount Vernon, IL, 62864-0034
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1144283300
Provider Name
Southern Illinois Consultants For Kidney Disease, S.c.
Credential
Provider Entity Type
Organization
Address
416 N 12Th St, Mount Vernon, IL, 62864-0034
Phone Number
618-244-4850
Fax Number
618-244-7985
Provider Enumeration Date
04/10/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4123105 01 BLUE CROSS BLUE SHIELD
3523854003 05 IL
institution
Provider Business Practice Location Address Details
Address
416 N 12Th St
City
Mount Vernon
State
Illinois
Zip
62864-4314
Phone Number
618-244-4850
Fax Number
618-244-7985
person
Provider Business Mailing Address Details
Address
416 N 12Th St
City
Mount Vernon
State
Illinois
Zip
62864-4314
Phone Number
618-244-4850
Fax Number
618-244-7985
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
060-007470 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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