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Organization

CHESTER CLINIC PROFESSIONAL CORP

Active
Other names
Steeleville Family Practice
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONNA M MARTIN (ADMINISTRATOR / CEO)
(618) 826-2388
Entity
Organization

Contact information

Practice address
2319 OLD PLANK RD, CHESTER, IL 62233
(618) 826-2388
(618) 826-3350
Mailing address
2319 OLD PLANK RD, CHESTER, IL 62233
(618) 826-2388
(618) 826-3350

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
IL
261Q00000X
Clinic/Center
261QR1300X
Rural Health Clinic/Center
060002310
IL

Other

Enumeration date
01/06/2006
Last updated
06/07/2010
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