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Organization

STAUNTON CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DIANE L DOBRINO (PRACTICE MANAGER)
(618) 635-3800
Entity
Organization

Contact information

Practice address
444 N EDWARDSVILLE ST, STAUNTON, IL 62088-1334
(618) 635-3800
(618) 635-3952
Mailing address
444 N EDWARDSVILLE ST, STAUNTON, IL 62088-1334
(618) 635-3800
(618) 635-3952

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
001
IL

Other

Enumeration date
09/26/2006
Last updated
07/21/2022
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