Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Granite City Clinic Corp

Organization Family Medicine Physician · NPI 1255387957

Granite City Clinic Corp is a Family Medicine Physician in Granite City, Illinois. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
5
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2044 Madison Ave Ste 27
Granite City, IL 62040-4641
Phone: (618) 451-7600
Fax: (618) 451-7685
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Surgery Physician Taxonomy 208600000X
Vascular Surgery Physician Taxonomy 2086S0129X

Record details

NPI number1255387957
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Laura Fey — Sr. Director Physician Rev Cycle · (615) 221-3641
NPI enumeratedMay 25, 2006
Last updated in NPPESJuly 7, 2023
Certification dateJuly 7, 2023
Mailing address1573 Mallory Ln Ste 100, Brentwood, TN 37027-2895

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