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Camia Custodio
Clinic/Center in San Jose, Illinois
NPI 1730520644

Camia Custodio is a Clinic/Center based in San Jose, IL. Camia Custodio practices in San Jose, IL. The NPI Number for Camia Custodio is 1730520644 and holds a License No. (Illinois).

The current practice location address for Camia Custodio is 301 S 4Th St, San Jose, IL and can be reached out via phone at 309-247-1203. You can also correspond with Camia Custodio through the mailing address at 301 S 4TH ST, SAN JOSE, IL - 62682-9527 (mailing address contact number: ).

Location: 301 S 4Th St, San Jose, IL, 62682-9527
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730520644
Provider Name
Camia Custodio
Credential
Provider Entity Type
Individual
Gender
Female
Address
301 S 4Th St, San Jose, IL, 62682-9527
Phone Number
309-247-1203
Fax Number
Provider Enumeration Date
07/09/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
301 S 4Th St
City
San Jose
State
Illinois
Zip
62682-9527
Phone Number
309-247-1203
Fax Number
person
Provider Business Mailing Address Details
Address
301 S 4Th St
City
San Jose
State
Illinois
Zip
62682-9527
Phone Number
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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