GREGORY S CHURCHILL PA

FAIRVIEW HEIGHTS MEDICAL GROUP SC

Dr GREGORY S CHURCHILL PA is a male medical professional, specializing in Physician Assistant. He graduated in 1996.

Contact

FAIRVIEW HEIGHTS MEDICAL GROUP SC

155 E BETHALTO DR
BETHALTO
IL
620101801

Tel: 6186323343

GREGORY S CHURCHILL PA Information

Npi 1053390237
Pac Id 4880798057
Professional Enrollment Id I20070327000675
Last Name CHURCHILL
First Name GREGORY
Middle Name S
Suffix
Gender M
Credential PA
Medical School Name OTHER
Graduation Year 1996
Primary Specialty PHYSICIAN ASSISTANT
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name FAIRVIEW HEIGHTS MEDICAL GROUP SC
Group Practice Pac Id 6800784083
Number Of Group Practice Members 206
Line 1 Street Address 155 E BETHALTO DR
Line 2 Street Address
Marker Of Address Line 2 Suppression
City BETHALTO
State IL
Zip Code 620101801
Phone Number 6186323343
Hospital Affiliation Ccn 1 140185
Hospital Affiliation Lbn 1 MEMORIAL HOSPITAL
Hospital Affiliation Ccn 2 140307
Hospital Affiliation Lbn 2 METRO-EAST SERVICES INC
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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