Organization
MID-AMERICA PSYCHIATRIC CONSULTANTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASIF HABIB MD (CO OWNER)
(618) 876-7519
Entity
Organization
Contact information
Practice address
2120 MADISON AVE, SUITE 404, GRANITE CITY, IL 62040
(618) 876-7515
(618) 876-7596
Mailing address
2120 MADISON AVE, SUITE 404, GRANITE CITY, IL 62040
(618) 876-7515
(618) 876-7596
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006030018
BLUE CROSS BLUE SHIELD
IL
05
—
505200402002
—
MO
Enumeration date
11/08/2006
Last updated
04/20/2016
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