Provider Demographics
NPI:1184633455
Name:M-CFHC
Entity Type:Organization
Organization Name:M-CFHC
Other - Org Name:HARRISBURG FAMILY HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUKHDARSHAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:BEDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-997-6666
Mailing Address - Street 1:305 N COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-1347
Mailing Address - Country:US
Mailing Address - Phone:618-252-5544
Mailing Address - Fax:618-253-7699
Practice Address - Street 1:305 N COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:IL
Practice Address - Zip Code:62946-1347
Practice Address - Country:US
Practice Address - Phone:618-252-5544
Practice Address - Fax:618-253-7699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2009-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL148940Medicare ID - Type Unspecified