DR. DEEDRA GAIL MCLAIN


Address: 300 W Oak St, Carbondale, IL 62901-1400
Phone: 6185366621

DR. DEEDRA GAIL MCLAIN (NPI# 1770635062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1770635062
Entity Type Individual
Full Name DR. DEEDRA GAIL MCLAIN
Other Name DEEDRA G CORZART
Credential M.D.
Practice Address 300 W Oak St
Carbondale
IL 62901-1400
Mailing Address Po Box 19639
Springfield
IL 62794-9639
Practice Telephone 6185366621
Mailing Telephone 2175453787
Enumeration Date 2007-01-17
Last Update Date 2020-07-07
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine 036107216 IL Allopathic & Osteopathic Physicians
Y 208D00000X General Practice 036107216 IL Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
2553 Ken Gray Blvd, West Frankfort, IL 628964174 6189323937 6189322734

Office Location

Street Address 300 W OAK ST
City CARBONDALE
State IL
Zip Code 62901-1400

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104443258 Kilmeny Clark Student in an Organized Health Care Education/Training Program 300 W Oak St, Carbondale, IL 62901-1400 2020-07-05
1033734272 Kristina Klaverkamp Physician Assistant 300 W Oak St, Carbondale, IL 62901-1400 2020-06-13
1891310546 Rustambir Singh Family Medicine 300 W Oak St, Carbondale, IL 62901-1400 2020-06-09
1144845884 Brian Scott Wilkinson Family Medicine 300 W Oak St, Carbondale, IL 62901-1400 2020-06-09
1699390344 Claire Francesca Melo Family Medicine 300 W Oak St, Carbondale, IL 62901-1400 2020-06-09
1548884398 Amanda Durham Student in an Organized Health Care Education/Training Program 300 W Oak St, Carbondale, IL 62901-1400 2020-06-07
1184248627 Serhiy Maslovsky Student in an Organized Health Care Education/Training Program 300 W Oak St, Carbondale, IL 62901-1400 2020-06-01
1306460902 Kendall Barnes Physician Assistant 300 W Oak St, Carbondale, IL 62901-1400 2020-05-31
1578186755 Zachary Carty Physician Assistant 300 W Oak St, Carbondale, IL 62901-1400 2020-05-22
1194347765 Kara Jordan Freeman Physician Assistant 300 W Oak St, Carbondale, IL 62901-1400 2020-05-17
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1588663801 Thomas J. Craparo General Practice 10 Dundaff St, Carbondale, PA 18407-1869 2005-07-19
1902056013 Thomas J Craparo General Practice 10 Dundaff St, Carbondale, PA 18407-1869 2008-09-25

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1306465786 Brightlife Regenerative Medical Clinic Lombard Sc General Practice 442 E Roosevelt Rd, Lombard, IL 60148-4630 2020-04-15
1851920524 Sahens Mezidor General Practice 228 Ridge Ave Apt G, Evanston, IL 60202-6409 2020-04-05
1447881487 Tyrian Healthcare Solutions, LLC General Practice 2120 W Heading Ave, West Peoria, IL 61604-5138 2020-01-29
1598302077 Enhance Medical LLC General Practice 1193 N Gary Ave, Carol Stream, IL 60188-9423 2019-12-04
1164067054 League Corp. General Practice 515 N State St Fl 8, Chicago, IL 60654-9102 2019-11-14
1679129977 Chronic Care Solutions LLC General Practice 3050 W Columbia Ave, Chicago, IL 60645-4006 2019-08-13
1205393972 Midwest Medical LLC General Practice 2001 Midwest Rd Ste Ll22, Oak Brook, IL 60523-1316 2019-02-28
1306311725 Genesis Integrative Medicine LLC General Practice 1881 S Randall Rd Ste C, Geneva, IL 60134-2532 2018-10-11
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Competitor

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City CARBONDALE
Zip Code 62901

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Dataset Information

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.

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