GRANITE CITY CLINIC CORP (NPI# 1598248106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598248106 |
| Entity Type | Organization |
| Organization Name | GRANITE CITY CLINIC CORP |
| Practice Address |
602 Farrish St Madison IL 62060-1567 |
| Mailing Address |
2100 Madison Ave Granite City IL 62040-4713 |
| Practice Telephone | 6185016261 |
| Mailing Telephone | 6187983845 |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |
| Authorized Official Name | ZACH KENNETH CHAPMAN (DIRECTOR PRACTICE MANAGEMENT) |
| Authorized Official Telephone | 6187983845 |
| Is Organization Subpart | Y |
| Parent Organization Name | GRANITE CITY CLINIC CORP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Madison School Based Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255387957 | Granite City Clinic Corp | Surgery | 2044 Madison Ave, Suite 27, Granite City, IL 62040-4641 | 2006-05-25 |
| 1003892464 | Granite City Clinic Corp | Anesthesiology | 2100 Madison Ave, Granite City, IL 62040-4701 | 2005-12-19 |
| Street Address |
602 FARRISH ST |
| City | MADISON |
| State | IL |
| Zip Code | 62060-1567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255514717 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 308 Madison Ave, Madison, IL 62060-1110 | 2007-12-07 |
| 1851305668 | Jason F. Kesselring | Pediatrics | 304 Madison Ave, Madison, IL 62060-1110 | 2006-07-28 |
| 1376959668 | Stay At Home Health Care Inc | Home Health | 1130 Douglas St, Madison, IL 62060-1122 | 2014-07-07 |
| 1174796734 | Madison County Urban League | Clinic/Center | 500 Madison Ave, Madison, IL 62060-1414 | 2008-04-03 |
| 1740461870 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 1425 6th St, Madison, IL 62060-1417 | 2007-11-16 |
| 1790083095 | Chestnut Health Systems, Inc | Case Management | 1425 6th St, Madison, IL 62060-1417 | 2011-03-10 |
| 1770850075 | Chestnut Health Systems, Inc. | Clinic/Center | 648 State St Bldg B, Madison, IL 62060-1420 | 2011-11-30 |
| 1902184054 | Chestnut Health Systems, Inc. | Clinic/Center | 648 State St Bldg A, Madison, IL 62060-1420 | 2011-07-22 |
| 1316126147 | Southern Illinois Healthcare Foundation, Inc. | Family Medicine | 648 State St, Madison, IL 62060-1420 | 2007-10-29 |
| 1073936530 | Kendra Jean Donaldson | Social Worker | 648 State St, Madison, IL 62060-1420 | 2014-02-03 |
| Find all providers in zip 62060 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1669918843 | All About You Healthcare LLC | Clinic/Center | 342 E Old Hickory Blvd, Madison, TN 37115-3937 | 2017-01-12 |
| 1548713332 | Wellness for Life | Clinic/Center | 630 Broadway St Ste 2a, Madison, IN 47250-3310 | 2016-07-27 |
| 1871863050 | Patrick J Oneill M.d., P.C. | Clinic/Center | 104 Spenryn Dr, Madison, AL 35758-1890 | 2012-01-05 |
| 1003191867 | Gluckstadt Special Care Clinic | Clinic/Center | 1716 Highway 51 Ste M, Madison, MS 39110-5020 | 2011-10-12 |
| 1104071836 | W Kevin Britt M.d. LLC | Clinic/Center | 1801 Clifty Drive, Madison, IN 47250-1627 | 2008-11-21 |
| 1366057986 | Avalon Family Care LLC | Clinic/Center | 540 Hughes Rd Ste 4, Madison, AL 35758-8959 | 2020-09-10 |
| 1447868757 | Advent Health LLC | Clinic/Center | 1230 Slaughter Rd Ste C, Madison, AL 35758-5901 | 2020-07-22 |
| 1902423825 | Madison Free Clinic, Inc | Clinic/Center | 410 North Main Street, Madison, VA 22727 | 2020-06-26 |
| Find all providers in MADISON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.