Mercy Clinic Illinois, LLC
Internal Medicine in Columbia, IL. Organization (NPI-2).
NPI number1164089124
StatusActive
Last updated in NPPESApr 28, 2025
Details
- NPI
- 1164089124
- Entity type
- Organization (NPI-2)
- Legal business name
- Mercy Clinic Illinois, LLC
- Organization subpart
- No
- Enumeration date
- May 24, 2019
- Certification date
- Apr 28, 2025
- Last updated
- Apr 28, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 208000000X | Pediatrics | – | – | |
| 363LF0000X | Nurse Practitioner, Family | – | – |
Practice location
1019 Valmeyer RdColumbia, IL 62236-4123
Phone 314-543-5244 · Fax 314-543-5248
Mailing address
1019 Valmeyer RdColumbia, IL 62236-4123
Phone 314-543-5244 · Fax 314-543-5248
Authorized official
Kerry Dunger
Executive Director - Finance
3143643707
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