St Anthony's Physician Organization of Illinois

NPI #1568853018 in Waterloo, Illinois

Provider Information

NPI Number
1568853018
Entity Type
Organization
Organization Name
St Anthony's Physician Organization of Illinois
Primary Specialty
Obstetrics & Gynecology
Enumeration Date
Feb 5, 2015
Last Updated
Feb 5, 2015

Practice Location

Address
509 HAMACHER ST
Address 2
STE 203
ZIP Code
62298-1592
Phone
(618) 939-0575

Authorized Official

Name
KENNETH VENUTO
Title
CHIEF FINANCIAL OFFICER
Phone
(314) 525-7340

Specialties & Taxonomy Codes

Specialty
Obstetrics & Gynecology

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