Organization
GIBSON COMMUNITY HOSPITAL ASSOCIATION
Active
Other names
THE ONARGA CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAN E WILSON (OFFICE MANAGER)
(815) 268-4840
Entity
Organization
Contact information
Practice address
109 N CHESTNUT ST, ONARGA, IL 60955-1255
(815) 268-4841
(815) 268-4845
Mailing address
109 N CHESTNUT ST, ONARGA, IL 60955-1255
(815) 268-4841
(815) 268-4845
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
208576
MEDICARE GROUP
IL
Enumeration date
07/23/2007
Last updated
08/28/2007
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