Southern Illinois Primary Care Associates, P.c.

NPI #1912904574 in Fairfield, Illinois

Provider Information

NPI Number: 1912904574
Entity Type: Organization
Organization Name: Southern Illinois Primary Care Associates, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: SOUTHERN ILLINOIS PRIMARY CARE ASSOCIATES, P.C
Primary Specialty: Family Medicine
Enumeration Date: Jun 28, 2005
Last Updated: Jan 14, 2011

Practice Location

Address: 209 NW 11TH ST
City: Fairfield
State: Illinois
ZIP Code: 62837-1218
Phone: (618) 842-4470

Authorized Official

Name: CATHY L HARTE
Title: DIRECTOR OF BUSINESS/CORP SECRETARY
Phone: (618) 842-4470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Obstetrics & Gynecology	207V00000X
Pediatrics	208000000X
Nurse Practitioner	363L00000X
Physician Assistant	363A00000X
Family Medicine	207Q00000X	Primary

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