Organization
FAMILY MEDICAL CLINIC OF LIVINGSTON COUNTY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILOMENA M FRANCIS M.D. (PRESIDENT)
(815) 584-1234
Entity
Organization
Contact information
Practice address
100 W SOUTH ST, DWIGHT, IL 60420-1368
(815) 584-1234
(815) 584-1716
Mailing address
100 W SOUTH ST, DWIGHT, IL 60420-1368
(815) 584-1234
(815) 584-1716
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036054806
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06100031
—
IL
Enumeration date
01/19/2011
Last updated
05/09/2011
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