Liberty Medical Center Coal City SC
Organization Active NPI Family Medicine Physician · Coal City, IL
NPI 1487948964 · NPPES record last updated Jun 2, 2011
Key facts
- NPI
- 1487948964
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036-125457 (IL)
- Legal business name
- LIBERTY MEDICAL CENTER COAL CITY SC
- Practice address
- 4 E North St
Coal City, IL 60416-1087 - Phone
- (815) 634-4099
- Fax
- (815) 634-4077
- NPI assigned
- Jun 2, 2011
- Organization subpart
- No
Authorized official
- Name
- Hassnain S Syed, M.D.,
- Title
- Director
- Phone
- (815) 634-4099
Practitioners 1
-
Gary L Williams, D.P.M.
National Provider Directory
Locations
4 E North St
Coal City, IL 60416
Phone (815) 518-5755
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 036-125457 | IL | Yes |
| Family Medicine Physician |
207Q00000X | 036-118250 | IL | |
| Family Medicine Physician |
207Q00000X | 03-6127143 | IL | |
| Internal Medicine Physician |
207R00000X | 036-087831 | IL |
Addresses
Primary practice location
4 E North St
Coal City, IL 60416-1087
Mailing address
4 E North St
Coal City, IL 60416-1087
Phone (815) 634-4099
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036-118250 | Medicaid | IL | |
| T01609 | Other | IL | MEDICARE PTAN |
| 036-087831 | Medicaid | IL | |
| 036-125457 | Medicaid | IL |
Other providers in Coal City, IL
- Burgundy L Lander
- Erin S Lane
- Hazel J Langcauon
- Lardi Chiropractic LTD
- Kelly Lardi
- Lighthouse Counseling, P.C.
- Alexander J Linko
- Haley M Lockhart
- Margaret Marsaglia
- Kassandra Lynn Marsala
All providers in Coal City, IL · Family Medicine Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.