Organization
HSHS MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELINDA CLARK CEO (CEO)
(217) 523-5406
Entity
Organization
Contact information
Practice address
615 N PROMENADE ST, HAVANA, IL 62644-1243
(217) 243-1101
(217) 243-5003
Mailing address
3215 EXECUTIVE PARK DR, SPRINGFIELD, IL 62703-4514
(217) 523-5406
(217) 492-9643
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/20/2015
Last updated
04/20/2015
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