Organization
MERCY CLINIC SPECIALISTS SERVICES-ILLINOIS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERRY DUNGER (EXECUTIVE DIRECTOR - FINANCE)
(314) 364-3707
Entity
Organization
Contact information
Practice address
2227 VADALABENE DR STE 200, MARYVILLE, IL 62062-5824
(314) 364-4347
Mailing address
2227 VADALABENE DR STE 200, MARYVILLE, IL 62062-5824
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500051406
—
MO
Enumeration date
08/08/2016
Last updated
04/28/2025
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