# GENERATION CLINICAL PARTNERS ACO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GCP ACO Illinois
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104674431
- **Authorized official:** REBECCA MUELLER (OFFICE MANAGER)
- **Authorized official phone:** (314) 925-0903

## Contact information

- **Practice address:** 623 HAMACHER ST, WATERLOO, IL 62298-1786
- **Practice address phone:** (314) 925-0903
- **Mailing address:** 10426 BAUR BLVD, SAINT LOUIS, MO 63132-1905
- **Mailing address phone:** (314) 925-0903

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/10/2024
- **Last updated:** 05/10/2024