institution
Main Street Medical Clinic Llc
Family Nurse Practitioner in Benton, Illinois
NPI 1649345125

Main Street Medical Clinic Llc is a Family Nurse Practitioner based in Benton, IL and is specialized in Family. Main Street Medical Clinic Llc practices in Benton, IL. The NPI Number for Main Street Medical Clinic Llc is 1649345125 and holds a License No. (Illinois).

The current practice location address for Main Street Medical Clinic Llc is 505 N Main St, Benton, IL and can be reached out via phone at 618-435-4310 and via fax at 618-435-4384.

Location: 505 N Main St, Benton, IL, 62812-1102
institution
Provider Profile Details
NPI Number
1649345125
Provider Name
Main Street Medical Clinic Llc
Credential
Provider Entity Type
Organization
Address
505 N Main St, Benton, IL, 62812-1102
Phone Number
618-435-4310
Fax Number
618-435-4384
Provider Enumeration Date
11/21/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
505 N Main St
City
State
Zip
62812-1102
Phone Number
618-435-4310
Fax Number
618-435-4384
person
Provider Business Mailing Address Details
Address
505 N Main St
City
State
Zip
62812-1102
Phone Number
618-435-4310
Fax Number
618-435-4384
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
(Illinois)
Definition
Definition to come...
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