# STAUNTON CLINIC, LLC

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

## Provider details

- **NPI number:** 1598866386
- **Authorized official:** MS. DIANE L DOBRINO (PRACTICE MANAGER)
- **Authorized official phone:** (618) 635-3800

## Contact information

- **Practice address:** 444 N EDWARDSVILLE ST, STAUNTON, IL 62088-1334
- **Practice address phone:** (618) 635-3800
- **Practice address fax:** (618) 635-3952
- **Mailing address:** 444 N EDWARDSVILLE ST, STAUNTON, IL 62088-1334
- **Mailing address phone:** (618) 635-3800
- **Mailing address fax:** (618) 635-3952

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR1300X | Rural Health Clinic/Center | 001 | IL | Yes |

## Other

- **Enumeration date:** 09/26/2006
- **Last updated:** 07/21/2022