Healthcare Provider Details

I. General information

NPI: 1881550804
Provider Name (Legal Business Name): FAIR WINDS DIRECT CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S CENTER ST STE 201
CLINTON IL
61727-1958
US

IV. Provider business mailing address

100 S CENTER ST STE 201
CLINTON IL
61727-1958
US

V. Phone/Fax

Practice location:
  • Phone: 309-682-0374
  • Fax:
Mailing address:
  • Phone: 309-682-0374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MORGAN MASSEY
Title or Position: OWNER
Credential: APRN
Phone: 217-519-3568