Healthcare Provider Details

I. General information

NPI: 1427800606
Provider Name (Legal Business Name): JOSEPH M ACCHIARDO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2024
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W KENWOOD AVE
DECATUR IL
62526-4368
US

IV. Provider business mailing address

102 W KENWOOD AVE STE 100
DECATUR IL
62526-4379
US

V. Phone/Fax

Practice location:
  • Phone: 217-872-3800
  • Fax:
Mailing address:
  • Phone: 217-872-3800
  • Fax: 217-872-0849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number125089090
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: