Organization
MICHAEL W ELLIOTT II MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY GOODWIN (RHC COORDINATOR)
(618) 546-5052
Entity
Organization
Contact information
Practice address
807 W CRAFT ST, ROBINSON, IL 62454
(618) 546-5052
(618) 544-2094
Mailing address
807 W CRAFT ST, ROBINSON, IL 62454
(618) 546-5052
(618) 544-2094
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036102103
—
IL
Enumeration date
07/06/2006
Last updated
10/07/2010
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