Organization
KASKASKIA MEDICAL CENTER, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DARMADI MD (MEDICAL DIRECTOR)
(618) 283-4445
Entity
Organization
Contact information
Practice address
1003 N 8TH ST, VANDALIA, IL 62471-1238
(618) 283-4445
(618) 283-4446
Mailing address
1003 N 8TH ST, VANDALIA, IL 62471-1238
(618) 283-4445
(618) 283-4446
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036097600
IL
208000000X
Pediatrics Physician
036097600
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097600
—
IL
Enumeration date
01/03/2006
Last updated
03/26/2018
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