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Organization
PEDIATRIC GROUP LLC
Active
Organization
PEDIATRIC GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHONDA LYNN FISHER (CEO)
(618) 993-0404
Entity
Organization
Contact information
Practice address
1175 CEDAR CT, CARBONDALE, IL 62901-5333
(618) 993-0404
(618) 993-1717
Mailing address
3412 OFFICE PARK DR, MARION, IL 62959-6477
(618) 993-0404
(618) 993-1717
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
NULL
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/09/2026
Last updated
10/09/2026
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