PROACTIVE MD IL SC

O FALLON, IL
NPI1881488773
Doing Business AsOE 520 HEALTH CENTER
Entity TypeOrganization
Authorized ContactMARK KEMBLE
Cmo
864-501-0751
Organization Subpart ?No
Primary Taxonomy261QP2300X Clinic/Center, Primary Care
Enumeration Date2025-04-07
Last Update Date2025-04-07
Business Address
PROACTIVE MD IL SC
1472 N GREEN MOUNT RD
O FALLON, IL 62269-3416
Phone number: 730-240-8040
Mailing Address
PROACTIVE MD IL SC
124 ALLAWOOD CT
SIMPSONVILLE, SC 29681-6207
Phone number: 864-501-0751