Organization
GACHUGU MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILSON GACHUGU NDUNGU NP (AUTHORIZED OFFICIAL/OWNER)
(618) 917-9463
Entity
Organization
Contact information
Practice address
1 E FERGUSON AVE, WOOD RIVER, IL 62095-1903
(618) 251-8138
(618) 251-8140
Mailing address
1 E FERGUSON AVE, WOOD RIVER, IL 62095-1903
(618) 917-9464
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
10/23/2020
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