The Little Clinic Illinois
NPI #1063461887 in Mount Vernon, Illinois
Provider Information
- NPI Number
- 1063461887
- Entity Type
- Organization
- Organization Name
- The Little Clinic Illinois
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- May 9, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 415 S 42ND ST
- City
- Mount Vernon
- State
- Illinois
- ZIP Code
- 62864-6266
- Phone
- (618) 246-9969
Authorized Official
- Name
- MRS. MARY CAY DECLUE, NP
- Title
- OWNER
- Phone
- (618) 246-9969
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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