Organization
CLINTON INTERNAL MEDICINE LLC
Active
Organization
CLINTON INTERNAL MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA LUSTER (OFFICE MANAGER)
(217) 935-7600
Entity
Organization
Contact information
Practice address
40 CLINTON PLZ, CLINTON, IL 61727-2100
(217) 935-7600
(217) 935-7603
Mailing address
40 CLINTON PLZ, CLINTON, IL 61727-2100
(217) 935-7600
(217) 935-7603
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA9151
RAILROAD MEDICARE
IL
Enumeration date
12/29/2006
Last updated
11/26/2008
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