Southern Illinois Allergy&Asthma Center,sc
Clinic/Center in Carbondale, IL. Organization (NPI-2).
NPI number1720175193
StatusActive
Last updated in NPPESSep 19, 2007
Details
- NPI
- 1720175193
- Entity type
- Organization (NPI-2)
- Legal business name
- Southern Illinois Allergy&Asthma Center,sc
- Organization subpart
- No
- Enumeration date
- Oct 6, 2006
- Last updated
- Sep 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 036-050797 | IL | Yes |
Practice location
1001 E Main St2a Ppe
Carbondale, IL 62901-3100
Phone 618-549-9385 · Fax 618-549-8795
Mailing address
1001 E Main St2a Ppe
Carbondale, IL 62901-3100
Phone 618-549-9385 · Fax 618-549-8795
Authorized official
Ronald Dean Mings
President
6185499385
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