NPI 1275824096

PC Associates LLC

Organisation Family Medicine Physician Belleville, IL

Practice location

Address: 2129 W. Main St., Belleville, IL 62223
Phone: (618) 257-2029
Mailing address: 4500 Memorial Dr Medical Affairs Credentialing Department, Belleville, IL 62226-5360

Authorised official

Name: Lisa K. McDonald
Title: Credentialing Coordinator
Phone: (618) 257-4644

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Illinois →

Registry record

NPI: 1275824096
Entity type: Organization
NPI issued: 27 Apr 2011
Record last updated: 15 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.