OrganizationActive
Charleston Primary Care Inc.
NPI 1770905952 · Primary Care Clinic/Center · Charleston, IL
Provider details
- NPI number
- 1770905952
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Danelle Jackson, Owner
Practice location
506 W Lincoln Ave
Suite 200
Charleston, IL 61920-2453
Phone: (217) 348-8730
Fax: (217) 345-7146
Mailing address
506 W Lincoln Ave
Charleston, IL 61920-2453
Registry dates
- Enumerated
- 2014-01-07
- Last updated
- 2014-01-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.