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Organization

COMWELL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMY BAUER (EHR SUPERVISOR)
(618) 282-6233
Entity
Organization

Contact information

Practice address
1101 OPDYKE ST, CHESTER, IL 62233-2004
(618) 282-6233
(888) 388-1971
Mailing address
10257 STATE ROUTE 3, RED BUD, IL 62278-4418
(618) 282-6233

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
02/27/2023
Last updated
05/18/2023
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