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St. Charles Family Medical Center, Sc
Specialist in St Charles, Illinois
NPI 1912054891

St. Charles Family Medical Center, Sc is a Specialist based in St Charles, IL. St. Charles Family Medical Center, Sc practices in St Charles, IL. The NPI Number for St. Charles Family Medical Center, Sc is 1912054891 and holds a License No. (Illinois).

The current practice location address for St. Charles Family Medical Center, Sc is 110 S 17Th St, St Charles, IL and can be reached out via phone at 630-377-2800 and via fax at 630-377-6774.

Location: 110 S 17Th St, St Charles, IL, 60174-2526
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1912054891
Provider Name
St. Charles Family Medical Center, Sc
Credential
Provider Entity Type
Organization
Address
110 S 17Th St, St Charles, IL, 60174-2526
Phone Number
630-377-2800
Fax Number
630-377-6774
Provider Enumeration Date
01/04/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
03060113 01 IL STATE LICENSE
667490 01 IL MEDICARE GROUP
institution
Provider Business Practice Location Address Details
Address
110 S 17Th St
City
St Charles
State
Illinois
Zip
60174-2526
Phone Number
630-377-2800
Fax Number
630-377-6774
person
Provider Business Mailing Address Details
Address
110 S 17Th St
City
St Charles
State
Illinois
Zip
60174-2526
Phone Number
630-377-2800
Fax Number
630-377-6774
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
(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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