Organization
ROBERT D CHILDERS MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DUNCAN CHILDERS MD (PRESIDENT)
(618) 498-8470
Entity
Organization
Contact information
Practice address
400 MAPLE SUMMIT RD, STE 300, JERSEYVILLE, IL 62052-2028
(618) 498-8470
(618) 498-8488
Mailing address
400 MAPLE SUMMIT RD, STE 300, JERSEYVILLE, IL 62052-2028
(618) 498-8470
(618) 498-8488
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DG2287
RAILROAD MEDICARE
—
Enumeration date
09/26/2007
Last updated
02/25/2008
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