Organization
GASTROHEALTH OF ILLINOIS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY HAMM (OFFICE MANAGER)
(309) 836-3387
Entity
Organization
Contact information
Practice address
5 DOCTORS LN, MACOMB, IL 61455-3369
(309) 836-3387
Mailing address
5 DOCTORS LN, MACOMB, IL 61455-3369
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036131897
IL
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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