Organization
HIGHLAND PEDIATRICS & ADOLESCENT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA FELDOTT-JOHNSON (PRESIDENT)
(618) 654-4449
Entity
Organization
Contact information
Practice address
1250 MERCANTILE DR, HIGHLAND, IL 62249-1239
(618) 654-4449
(618) 654-3974
Mailing address
1250 MERCANTILE DR, HIGHLAND, IL 62249-1239
(618) 654-4449
(618) 654-3974
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
04/02/2007
Last updated
10/13/2011
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