# INSTACLINIC OF ILLINOIS, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447351028
- **Authorized official:** MRS. PATRICIA M SOHN RN (MANAGER)
- **Authorized official phone:** (314) 238-1275

## Contact information

- **Practice address:** 2811 HOMER ADAMS PARKWAY, ALTON, IL 62002
- **Practice address phone:** (314) 238-1275
- **Practice address fax:** (314) 238-1250
- **Mailing address:** 10805 SUNSET OFFICE DRIVE, SUITE 300, ST. LOUIS, MO 63127
- **Mailing address phone:** (314) 238-1275
- **Mailing address fax:** (314) 238-1250

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 08/26/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 216708 | NEW PTAN MASS IMMUNIZER PROVIDER NUMBER | IL |