| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1740708171 | GOODIN | THERESA | ALEISE | 1301 E WALNUT ST | CARBONDALE | IL | 629015004 | |
| 1255844296 | MCKEE | MANDY | JO | 1301 E WALNUT ST | CARBONDALE | IL | 629015004 | |
| 1295244242 | PRUDENCIO | AMY | ELIZABETH | 1301 E WALNUT ST | CARBONDALE | IL | 629015004 |