Modert Family Practice, Ltd.
NPI #1255311700 in Mount Vernon, Illinois
Provider Information
- NPI Number
- 1255311700
- Entity Type
- Organization
- Organization Name
- Modert Family Practice, Ltd.
- Primary Specialty
- Family Medicine
- Enumeration Date
- Jan 19, 2006
- Last Updated
- Nov 4, 2020
Practice Location
- Address
- 1 DOCTORS PARK RD STE C
- City
- Mount Vernon
- State
- Illinois
- ZIP Code
- 62864-6251
- Phone
- (618) 244-1234
Authorized Official
- Name
- DR. SARA K. MODERT, D.O.
- Title
- PRESIDENT
- Phone
- (618) 244-1234
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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