Organization
CHESTER MEDICAL GROUP LLC
Active
Other names
Chester Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA M MARTIN (ADMINISTRATOR)
(618) 826-2388
Entity
Organization
Contact information
Practice address
1900 STATE ST, CHESTER, IL 62233-1116
(618) 826-4581
Mailing address
1900 STATE ST, CHESTER, IL 62233-1116
(618) 826-4581
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/12/2011
Last updated
10/11/2013
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