THE CARBONDALE CLINIC - NPI 1043378565 - Clinic/Center in Carbondale, IL

Q: What is The Carbondale Clinic's NPI number?

The NPI number for The Carbondale Clinic is 1043378565. It was assigned to this organization in the NPPES registry on December 5, 2006.

Q: What is The Carbondale Clinic's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

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About The Carbondale Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THE CARBONDALE CLINIC (NPI 1043378565) is a healthcare organization registered as a multi-specialty in Carbondale, Illinois and active in the NPI registry since December 2006. The organization lists Allan Norman, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1043378565

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameTHE CARBONDALE CLINIC

Location Address2601 W MAIN STCarbondale, IL 62901-1031

Mailing Address2601 W Main StCarbondale, IL 62901-1031 · (618) 457-5200 · Fax (618) 457-4542

Phone(618) 457-5200

Fax(618) 549-5128

Organization SubpartNo

Authorized OfficialAllan NormanChief Executive Officer · (618) 457-5200

Enumeration DateDecember 5, 2006

Last NPPES UpdateMay 8, 2008

✔ NPI 1043378565 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

License✔ Licensed in IL · 042-000266

2601 W MAIN ST, Carbondale, IL 62901

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Other Identifiers 3

Other614350IL · Legacy

Other3910515IL · Bcbs

Other690006448IL · Railroad Medicare

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MELISSA A MARTINEZ MATEO M.D.

Internal Medicine (Gastroenterology)