Organization
PSYCHIATRIC SERVICES OF SOUTHERN ILLINOIS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY S CHALFANT D.O (PSYCHIATRIST)
(618) 236-6501
Entity
Organization
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 990, BELLEVILLE, IL 62223-5000
(618) 236-6501
(618) 236-6551
Mailing address
2900 FRANK SCOTT PKWY W, SUITE 990, BELLEVILLE, IL 62223-5000
(618) 236-6501
(618) 236-6551
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K25958
MEDICARE ID
IL
Enumeration date
04/23/2010
Last updated
08/05/2010
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