FORREST FAMILY PRACTICE CENTER LLC NPI 1104003086

NPI Information

  • NPI: 1104003086
  • Provider Name: FORREST FAMILY PRACTICE CENTER LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: FORREST FAMILY PRACTICE LLC
  • Address: 122 E WABASH AVE
    FORREST, IL
    ZIP 61741
  • Phone: (815) 657-8707

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NPI Details

FORREST FAMILY PRACTICE CENTER LLC is a family medicine in Forrest, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. FORREST FAMILY PRACTICE CENTER LLC NPI is 1104003086. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Forrest Family Practice Llc.

The provider's business location address is:

122 E WABASH AVE
FORREST, IL
ZIP 61741
Phone: (815) 657-8707
Fax: (815) 657-8717

The provider's authorized official is Benjamin E Brewer .
The authorized official title is Owner and has the following contact phone number (815) 657-8707.

The enumeration date for this NPI number is 1/23/2008 and was last updated on 7/2/2009.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

Other Identifiers

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

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1148903MEDICARE OSCAR/CERTIFICATIONILLINOIS
2364468162001MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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