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JAY RISEMAN MD LTD NPI 1508982299


NPI Information

NPI: 1508982299
Provider Name: JAY RISEMAN MD LTD
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2524 FARRAGUT DR
SUITE C
SPRINGFIELD, IL
ZIP 62704
Phone: (217) 546-8711
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JAY RISEMAN MD LTD is a family medicine in Springfield, 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. JAY RISEMAN MD LTD NPI is 1508982299. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2524 FARRAGUT DR
SUITE C
SPRINGFIELD, IL
ZIP 62704-400
Phone: (217) 546-8711
Fax: (217) 546-8720

The provider's authorized official is Jay A Riseman .
The authorized official title is Officer and has the following contact phone number (217) 629-8711.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 10/31/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryILLINOISNo
2207Q00000XFamily MedicineILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
13001OTHERNEIC SITE ID,NSF BAO-7
2087768OTHERILLINOISHEALTH ALLIANCE
3E80209MEDICARE UPINILLINOIS
4945130MEDICARE PINILLINOIS
5148336OTHERILLINOISHEALTHLINK NETWORK ID
608400721OTHERILLINOISBLUECROSS BLUESHIELD

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: 4/28/2024

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