Organization
CHILDRENS ILLINOIS INC
Active
Organization
CHILDRENS ILLINOIS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE MCKEE (VICE PRESIDENT)
(314) 454-6044
Entity
Organization
Contact information
Practice address
2122 TROY RD STE 120, EDWARDSVILLE, IL 62025-2540
(618) 800-4620
Mailing address
1 CHILDRENS PL STE 3S-36, SAINT LOUIS, MO 63110-1002
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
—
—
261QH0700X
Hearing and Speech Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
09/20/2021
Last updated
09/23/2021
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