Organization
PRAIRIE PSYCHIATRY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY JOHN JUNG I M.D. (OWNER)
(618) 235-1582
Entity
Organization
Contact information
Practice address
301 W LINCOLN ST, SUITE 106, BELLEVILLE, IL 62220-1901
(618) 235-1582
(618) 235-2473
Mailing address
301 W LINCOLN ST, SUITE 106, BELLEVILLE, IL 62220-1901
(618) 235-1582
(618) 235-2473
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
IL
Other
Enumeration date
10/18/2006
Last updated
08/22/2020
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