Organization
WOMENS HEALTH ASSOCIATES OF SOUTHERN ILLINOIS, S. C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE L SIMONTON-SMITH M.D. (PRESIDENT)
(618) 242-4162
Entity
Organization
Contact information
Practice address
1708 JEFFERSON AVE, MOUNT VERNON, IL 62864-4309
(618) 242-4162
(618) 242-8445
Mailing address
PO BOX 1614, MOUNT VERNON, IL 62864-0032
(618) 242-4162
(618) 242-8445
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH3404
RAILROAD MEDICARE
IL
Enumeration date
11/25/2006
Last updated
08/22/2020
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