MODERT FAMILY PRACTICE LTD. NPI 1255311700

NPI Information

  • NPI: 1255311700
  • Provider Name: MODERT FAMILY PRACTICE, LTD.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 14D0705560
  • Address: 1 DOCTORS PARK RD STE C
    MOUNT VERNON, IL
    ZIP 62864
  • Phone: (618) 244-1234

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NPI Details

MODERT FAMILY PRACTICE, LTD. is a family medicine in Mount Vernon, 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. MODERT FAMILY PRACTICE, LTD. NPI is 1255311700. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1 DOCTORS PARK RD STE C
MOUNT VERNON, IL
ZIP 62864-251
Phone: (618) 244-1234

The provider's authorized official is Sara K. Modert .
The authorized official title is President and has the following contact phone number (618) 244-1234.

The CLIA number assigned to this NPI record is 14D0705560 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/19/2006 and was last updated on 11/4/2020.

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 MedicineILLINOISYes

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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