RECOVERUSCENTERS-CARBONDALE LLC (NPI# 1831748573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831748573 |
| Entity Type | Organization |
| Organization Name | RECOVERUSCENTERS-CARBONDALE LLC |
| Practice Address |
2250 Reed Station Pkwy Ste 204 Carbondale IL 62901-8104 |
| Practice Telephone | 6185199445 |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2019-09-05 |
| Authorized Official Name | DR. MILTON THEODORE MORTER III (OWNER) |
| Authorized Official Telephone | 4796199320 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
2250 REED STATION PKWY STE 204 |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-8104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003465824 | Milton Theodore Morter IIi | Chiropractor | 2250 Reed Station Pkwy Ste 204, Carbondale, IL 62901-8104 | 2019-09-04 |
| 1952939563 | Sydelle Fulk | Counselor | 2250 Reed Station Pkwy Ste 204, Carbondale, IL 62901-8104 | 2020-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609303320 | Brianne C Brown | Family Medicine | 1111 N Milwaukee Ave Unit 242, Vernon Hills, IL 60061-1658 | 2017-05-11 |
| 1649553892 | Physicians Community Medical Center North, S.c. | Family Medicine | 5320 159th St # 2n, Oak Forest, IL 60452-4705 | 2011-09-23 |
| 1538469739 | John Thomas Johns Jr. | Family Medicine | 210 N. Ashland, Chicago, IL 60607-1402 | 2010-10-22 |
| 1548447956 | Total Care Medical Clinic | Family Medicine | 6929 Ogden Ave, Berwyn, IL 60402-3649 | 2008-01-28 |
| 1205979028 | Gloria J Mouzon | Family Medicine | 140 N Ashland Ave, Chicago, IL 60607-1802 | 2007-02-14 |
| 1760448674 | Richard J Ready | Family Medicine | 999 Oakmont Plaza Dr Ste 100, Westmont, IL 60559-1381 | 2006-04-21 |
| 1841251378 | Britt Michael Borden | Family Medicine | 180 N Stetson Ave, Chicago, IL 60601-6710 | 2006-04-02 |
| 1992704381 | James Edward Beckett | Family Medicine | 326 W 64th St, St Bernard Hospital Dept Radiology, Chicago, IL 60621-3114 | 2005-07-18 |
| 1912519786 | Shark Addiction Treatment | Family Medicine | 1111 N Milwaukee Ave Unit 242, Vernon Hills, IL 60061-1658 | 2020-08-21 |
| 1609303940 | Great Heights Medical Ltd. | Family Medicine | 315 E Mckinley Rd, Ottawa, IL 61350-4805 | 2017-05-17 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
Please comment or provide details below to improve the information on RECOVERUSCENTERS-CARBONDALE LLC.
| 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.