# LAMOINE VALLEY CLINIC, S. C.

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

## Provider details

- **NPI number:** 1861485252
- **Authorized official:** KATHY HAMM (OFFICE MANAGER)
- **Authorized official phone:** (309) 836-3387

## Contact information

- **Practice address:** 5 DOCTORS LN, MACOMB, IL 61455-3369
- **Practice address phone:** (309) 836-3387
- **Practice address fax:** (309) 833-1023
- **Mailing address:** 5 DOCTORS LN, MACOMB, IL 61455-3369
- **Mailing address phone:** (309) 836-3387
- **Mailing address fax:** (309) 833-1023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 042618390 | IL | Yes |

## Other

- **Enumeration date:** 08/31/2005
- **Last updated:** 08/02/2010