BACKROAD HEALTH CARE NPI 1467857086

NPI Information

  • NPI: 1467857086
  • Provider Name: BACKROAD HEALTH CARE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Address: 7825A EAST GRANT ROAD
    WALNUT HILL, IL
    ZIP 62893
  • Phone: (618) 545-0707

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NPI Details

BACKROAD HEALTH CARE is a family nurse practitioner in Walnut Hill, IL. BACKROAD HEALTH CARE NPI is 1467857086. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7825A EAST GRANT ROAD
WALNUT HILL, IL
ZIP 62893
Phone: (618) 545-0707

The provider's authorized official is Paul Havrilka .
The authorized official title is Owner/provider and has the following contact phone number (618) 545-0707.

The enumeration date for this NPI number is 10/24/2014 and was last updated on 10/24/2014.

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
1363LF0000XNurse PractitionerFamily209010715ILLINOISYes

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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