Organization
SOUTHWEST ILLINOIS HEALTH SERVICES, LLP
Active
Other names
PET/CT Imaging
Organization subpart
No
Provider details
NPI number
Authorized official
JANE GUSMANO (VICE PRESIDENT)
(618) 257-5607
Entity
Organization
Contact information
Practice address
4000 NORTH ILLINOIS, SUITE A, SWANSEA, IL 62226-1496
(618) 236-9770
(618) 236-9780
Mailing address
4000 NORTH ILLINOIS, SUITE A, SWANSEA, IL 62226-1496
(618) 236-9770
(618) 236-9780
Taxonomy
Speciality
Code
Description
License number
State
2085N0904X
Nuclear Radiology Physician
Primary
IL-01836-01
IL
Other
Enumeration date
08/26/2005
Last updated
07/18/2019
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