Organization
THE CARBONDALE CLINIC AMBULATORY SURGICAL TREATMENT CENTER
Active
Parent organization
CARBONDALE CLINIC, S.C.
Organization subpart
Yes
Provider details
NPI number
Legal business name
CARBONDALE CLINIC, S.C.
Authorized official
MR. ALLAN N NORMAN (CHIEF EXECUTIVE OFFICER)
(618) 457-5200
Entity
Organization
Contact information
Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Mailing address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7001019
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014101
HAMP
IL
01
—
116485
HEALTHLINK
IL
01
—
141028
MEDICARE GROUP NUMBER
IL
01
—
196077
GHP
IL
01
—
490000473
RAILROAD MEDICARE NUMBER
IL
01
—
533
BCBS
IL
Enumeration date
12/29/2006
Last updated
05/09/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us