Healthcare Provider Details

I. General information

NPI: 1225167455
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF DECATUR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3021 N OAKLAND AVE
DECATUR IL
62526-1607
US

IV. Provider business mailing address

3021 N OAKLAND AVE
DECATUR IL
62526-1607
US

V. Phone/Fax

Practice location:
  • Phone: 217-877-6474
  • Fax: 217-877-9452
Mailing address:
  • Phone: 217-877-6474
  • Fax: 217-877-9452

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0050X
TaxonomyNon-Surgical Family Planning Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STEPHANI HUSTON COX
Title or Position: DIRECTOR OF PATIENT SERVICES
Credential: BS, APN, CNP
Phone: 217-877-6474