JEFFREY RYAN SPARKS D.O. NPI 1780935197

NPI Information

  • NPI: 1780935197
  • Provider Name: JEFFREY RYAN SPARKS, D.O.
  • Classification: Otolaryngology - 207YX0905X
  • Specialization: Otolaryngology/Facial Plastic Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 515 E GRANT ST
    SUITE 113
    MACOMB, IL
    ZIP 61455
  • Phone: (309) 833-6937

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NPI Details

Jeffrey Ryan Sparks, D.O. is an otolaryngology/facial plastic surgery otolaryngology in Macomb, IL with 18 years of experience. The provider is an otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. Jeffrey Ryan Sparks, D.O. NPI is 1780935197. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduation Year:2008

The provider's business location address is:

515 E GRANT ST
SUITE 113
MACOMB, IL
ZIP 61455-368
Phone: (309) 833-6937

The NPI 1780935197 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 9/25/2012 and was last updated on 2/28/2014.

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
1207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery2009026507MISSOURINo
2207YX0905XOtolaryngologyOtolaryngology/Facial Plastic Surgery036-132116ILLINOISYes

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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