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Organization

GRANITE CITY CLINIC CORP

Active
Parent organization
GRANITE CITY CLINIC CORP
Other names
Madison School Based Health Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
GRANITE CITY CLINIC CORP
Authorized official
ZACH KENNETH CHAPMAN (DIRECTOR PRACTICE MANAGEMENT)
(618) 798-3845
Entity
Organization

Contact information

Practice address
602 FARRISH ST, MADISON, IL 62060-1567
(618) 501-6261
Mailing address
2100 MADISON AVE, GRANITE CITY, IL 62040-4713
(618) 798-3845

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Enumeration date
09/10/2018
Last updated
09/10/2018
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