Organization
MEMORIAL HOSPITAL OF CARBONDALE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN A WHITESIDE OTR/L (OCCUPATIONAL THERAPIST)
(618) 833-1506
Entity
Organization
Contact information
Practice address
515 E. VIENNA SUITE 1, ANNA, IL 62906
(618) 833-1506
Mailing address
735 CASPER CHURCH ROAD, COBDEN, IL 62920
(618) 833-8227
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
IL
Other
Enumeration date
06/24/2006
Last updated
08/22/2020
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