| NPI | 1962689240 |
|---|---|
| Doing Business As | SOUTHERN ILLINOIS IMMEDIATE CARE, LLC |
| Entity Type | Organization |
| Authorized Contact | KELLI S BOSS Billing Department 618-998-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2011-02-02 |