Organization
FAMILY HEALTHCARE CLINIC & REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUGUSTINE EBONG (PRESIDENT/AGENT)
(618) 253-8863
Entity
Organization
Contact information
Practice address
701 N COMMERCIAL ST, SUITE 4, HARRISBURG, IL 62946-3335
(618) 253-8863
(618) 253-8864
Mailing address
701 N COMMERCIAL ST, SUITE 4, HARRISBURG, IL 62946-3335
(618) 253-8863
(618) 253-8864
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
148973
IL
Other
Enumeration date
08/02/2006
Last updated
08/22/2020
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