Organization
BELOIT CLINIC, S.C.
Active
Other names
South Beloit Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
RUTH GRAY (ASSISTANT ADMINISTRATOR)
(608) 364-1348
Entity
Organization
Contact information
Practice address
1701 BLACKHAWK BLVD, SOUTH BELOIT, IL 61080-2407
(608) 364-1348
(608) 364-2338
Mailing address
1905 E HUEBBE PKWY, BELOIT, WI 53511-1842
(608) 364-1348
(608) 364-2338
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32069700
—
WI
Enumeration date
03/19/2007
Last updated
08/22/2020
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