Southern Illinois Histology, LLC
NPI #1215208798 in Granite City, Illinois
Provider Information
- NPI Number
- 1215208798
- Entity Type
- Organization
- Organization Name
- Southern Illinois Histology, LLC
- Primary Specialty
- Pathology - Anatomic Pathology & Clinical Pathology
- Enumeration Date
- Jan 16, 2012
- Last Updated
- Jan 16, 2012
Practice Location
- Address
- 2100 MADISON AVE
- City
- Granite City
- State
- Illinois
- ZIP Code
- 62040-4701
- Phone
- (618) 798-3000
Authorized Official
- Name
- DOLPH D HAEGE, M.D.
- Title
- PRESIDENT
- Phone
- (618) 798-3000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pathology - Anatomic Pathology & Clinical Pathology — Anatomic Pathology & Clinical Pathology |
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