Maple Street Clinic Ltd
NPI #1245252204 in Lawrenceville, Illinois
Provider Information
- NPI Number
- 1245252204
- Entity Type
- Organization
- Organization Name
- Maple Street Clinic Ltd
- Primary Specialty
- Psychiatry & Neurology - Psychiatry
- Enumeration Date
- Jul 25, 2006
- Last Updated
- Mar 19, 2014
Practice Location
- Address
- 1401 15TH ST
- City
- Lawrenceville
- State
- Illinois
- ZIP Code
- 62439-2223
- Phone
- (618) 839-4618
Authorized Official
- Name
- DR. LINDA E HUNGERFORD, MD
- Title
- PRESIDENT
- Phone
- (618) 839-1561
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychiatry & Neurology - Psychiatry — Psychiatry |
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