NPI 1003120387

PC Associate, LLC

Organisation Family Medicine Physician Belleville, IL

Practice location

Address: 4600 Memorial Dr STE 160, Belleville, IL 62226-5368
Phone: (618) 235-0460
Fax: (618) 235-1464
Mailing address: 4500 Memorial Dr Medical Affairs Credentialing Department, Belleville, IL 62226-5360

Authorised official

Name: James B. Davis
Title: Executive Director
Phone: (618) 257-4644

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Illinois →

Registry record

NPI: 1003120387
Entity type: Organization
NPI issued: 29 Jul 2010
Record last updated: 25 Feb 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.