Healthcare Provider Details

I. General information

NPI: 1811087604
Provider Name (Legal Business Name): MULTI-CARE SPECIALISTS SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3986 MARYVILLE RD
GRANITE CITY IL
62040-4191
US

IV. Provider business mailing address

PO BOX 20259
SPRINGFIELD IL
62708-0259
US

V. Phone/Fax

Practice location:
  • Phone: 618-797-0618
  • Fax: 618-797-2243
Mailing address:
  • Phone: 618-797-0618
  • Fax: 618-797-2243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number036099405
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036099405
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036085633
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070008964
License Number StateIL

VIII. Authorized Official

Name: JONATHON BROOKS
Title or Position: V-PRESIDENT
Credential: DPC
Phone: 618-797-0618