Organization
CHESTER MEDICAL GROUP, LLC
Active
Other names
Chester Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA MARTIN (ADMINISTRATOR)
(618) 826-2388
Entity
Organization
Contact information
Practice address
2319 OLD PLANK RD, CHESTER, IL 62233-1153
(618) 826-2388
(618) 826-3350
Mailing address
2319 OLD PLANK RD, CHESTER, IL 62233-1153
(618) 826-2388
(618) 826-5798
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
12/02/2011
Last updated
10/03/2013
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