Murphysboro Internal Medicine Clinic

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

036110916 Issued in IL

Legal business name

MURPHYSBORO INTERNAL MEDICINE CLINIC

Practice address

1032 N 6TH St
Murphysboro, IL 62966-2267

Phone

(618) 684-6408

Fax

(618) 684-3637

NPI assigned

Oct 2, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Chante T Trinh, M.D.NPI 1093827727

Title

President

Phone

(618) 684-6408

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chante Thanh Trinh, M.D.

  • Emergency Medicine Physician
  • Herrin, IL
  • NPI 1093827727

  Geriatric Medicine

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1114114345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1032 N 6TH ST",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629662267",
            "telephone_number": "618-684-6408",
            "fax_number": "618-684-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1032 N 6TH ST",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629662267",
            "telephone_number": "618-684-6408",
            "fax_number": "618-684-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MURPHYSBORO INTERNAL MEDICINE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-02",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "TRINH",
        "authorized_official_first_name": "CHANTE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-684-6408",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "IL",
            "license": "036110916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS IL",
            "identifier": "03932025",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036110916",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth A. Miner, R.N., C.N.P., BS
• Victoria Moore
• Kelsey R Morton, PHARM.D.
• Murphysboro Chiropractic Clinic, PC
• Murphysboro Cu SCH Dist 186
• Murphysoboro Counseling Center, LLC
• Paula Monique Musumhi
• Hoai P Nguyen, DMD
• Melanie Jean Nordstrom, L.C.S.W.
• Norrenberns Foods Inc

• Geriatric Medicine (Internal Medicine) Physician in Murphysboro, IL
• Providers in Murphysboro, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.