Healthcare Provider Details

I. General information

NPI: 1376962076
Provider Name (Legal Business Name): RICHELLE VOLK F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1106 N MERCHANT ST
EFFINGHAM IL
62401-2128
US

IV. Provider business mailing address

1106 N MERCHANT ST
EFFINGHAM IL
62401-2128
US

V. Phone/Fax

Practice location:
  • Phone: 217-342-7000
  • Fax: 217-342-7002
Mailing address:
  • Phone: 217-342-7000
  • Fax: 217-342-7002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209011449
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: