Organization
STATERA HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CALEB SUTTON (BUSINESS OPERATIONS MANAGER)
(618) 833-1691
Entity
Organization
Contact information
Practice address
100 DR WARREN TUTTLE DR, HARRISBURG, IL 62946-2718
(618) 833-1691
Mailing address
2250 N ILLINOIS AVE, CARBONDALE, IL 62901-5612
(618) 833-1691
(618) 861-5302
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Enumeration date
05/01/2019
Last updated
05/04/2023
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