Organization
SI MEDICAL WEIGHT LOSS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL ELIZABETH CANDLER NP-C (NURSE PRACTITIONER)
(618) 741-4454
Entity
Organization
Contact information
Practice address
123 LINCOLN PLACE CT, BELLEVILLE, IL 62221-5884
(618) 234-5677
(618) 234-5679
Mailing address
123 LINCOLN PLACE CT, BELLEVILLE, IL 62221-5884
(618) 234-5677
(618) 234-5679
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
209012741
IL
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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