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PASSAVANT PHYSICIAN ASSOCIATION NPI 1720370778


NPI Information

NPI: 1720370778
Provider Name: PASSAVANT PHYSICIAN ASSOCIATION

Doing Business As: PASSAVANT INTERNAL MEDICINE RURAL HEALTH CLINIC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
559 N WESTGATE AVE
JACKSONVILLE, IL
ZIP 62650
Phone: (217) 243-5474
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PASSAVANT PHYSICIAN ASSOCIATION is an internal medicine in Jacksonville, IL. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PASSAVANT PHYSICIAN ASSOCIATION NPI is 1720370778. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Passavant Internal Medicine Rural Health Clinic.

The provider's business location address is:

559 N WESTGATE AVE
JACKSONVILLE, IL
ZIP 62650-156
Phone: (217) 243-5474

The provider's authorized official is Stephen G Lee .
The authorized official title is Manager and has the following contact phone number (217) 479-5890.

The enumeration date for this NPI number is 5/10/2011 and was last updated on 7/6/2011.


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
1207R00000XInternal Medicine036056832ILLINOISNo
2363LA2200XNurse PractitionerAdult Health209004842ILLINOISNo
3207R00000XInternal Medicine036091905ILLINOISYes

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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