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Organization
PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
Active
Organization
PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
Active
Parent organization
PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
Other names
St marys Good Samaritan medical group
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHYSICIAN SERVICES CORP OF SOUTHERN ILLINOIS
Authorized official
MR. RICHARD HUNTINGTON (VP FINANCIAL DEVELOPMENT)
(618) 241-2204
Entity
Organization
Contact information
Practice address
8 CUSUMANO PROFESSIONAL PLAZA DR, MOUNT VERNON, IL 62864-6736
(618) 242-7819
Mailing address
413 MAIN ST, MOUNT VERNON, IL 62864
(618) 532-9350
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
0004705
IL
Other
Enumeration date
06/09/2005
Last updated
04/02/2009
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