PRAIRIE CARDIOVASCULAR CONSULTANTS LTD. NPI 1982714218

NPI Information

PRAIRIE CARDIOVASCULAR CONSULTANTS, LTD. is a multi-specialty clinic center in Springfield, IL. PRAIRIE CARDIOVASCULAR CONSULTANTS, LTD. NPI is 1982714218. The provider is registered as an organization entity type.

The provider's business location address is:

619 E MASON ST STE 4P57
SPRINGFIELD, IL
ZIP 62701-034
Phone: (217) 788-0706
Fax: (217) 788-0848

The provider's authorized official is Andrew Watson .
The authorized official title is Cfo and has the following contact phone number (217) 788-0706.

The CLIA number assigned to this NPI record is 14D2138636 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/30/2006 and was last updated on 8/17/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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