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Organization
WOMENS HEALTH ASSOCIATES OF SOUTHERN ILLINOIS, S. C.
Active
Organization
WOMENS HEALTH ASSOCIATES OF SOUTHERN ILLINOIS, S. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE L SIMONTON-SMITH M.D. (PRESIDENT)
(618) 242-4162
Entity
Organization
Contact information
Practice address
1708 JEFFERSON AVE, MOUNT VERNON, IL 62864-4309
(618) 242-4162
(618) 242-8445
Mailing address
PO BOX 1614, MOUNT VERNON, IL 62864-0032
(618) 242-4162
(618) 242-8445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH3404
RAILROAD MEDICARE
IL
Enumeration date
11/25/2006
Last updated
08/22/2020
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