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1477527604
CHRISTOPHER WILSON MODERT
MOUNT VERNON, IL
NPI
1477527604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: IL 036079242)
Enumeration Date
2006-02-14
Last Update Date
2020-11-04
Business Address
CHRISTOPHER WILSON MODERT D.O.
1 DOCTORS PARK RD STE C
MOUNT VERNON, IL 62864-6251
Phone number: 618-244-1234
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Mailing Address
CHRISTOPHER WILSON MODERT D.O.
PO BOX 802
MOUNT VERNON, IL 62864-0017
Phone number: 618-244-1234
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