# EVERSIDE HEALTH LLC FAIRVIEW HEIGHTS HEALTH CTR

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Marathon Health, Fairview Heights IL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1457005423
- **Authorized official:** JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
- **Authorized official phone:** (704) 936-5546

## Contact information

- **Practice address:** 5031 N ILLINOIS ST, FAIRVIEW HEIGHTS, IL 62208-3453
- **Practice address phone:** (704) 529-6161
- **Mailing address:** 4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/09/2022
- **Last updated:** 09/17/2026