Organization
CARBONDALE COMMUNITY HIGH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE KOSCO (FINANCIAL OFFICER)
(618) 457-4722
Entity
Organization
Contact information
Practice address
330 S GIANT CITY RD, CARBONDALE, IL 62902-5042
(618) 457-4722
(618) 457-3353
Mailing address
330 S GIANT CITY RD, CARBONDALE, IL 62902-5042
(618) 457-4722
(618) 457-3353
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
IL
Other
Enumeration date
03/11/2008
Last updated
04/20/2008
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