Organization
KEWANEE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES S LINDBOM MD (OWNER)
(309) 853-5360
Entity
Organization
Contact information
Practice address
204 W SOUTH ST, KEWANEE, IL 61443-3661
(309) 853-5360
(309) 853-5106
Mailing address
204 W SOUTH ST, KEWANEE, IL 61443-3661
(309) 853-5360
(309) 853-5106
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098462
—
IL
Enumeration date
09/14/2007
Last updated
12/06/2007
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