Healthcare Provider Details

I. General information

NPI: 1932687183
Provider Name (Legal Business Name): AFFINITY PATIENT COORDINATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 PLEASANT RUN STE B
SPRINGFIELD IL
62711-6304
US

IV. Provider business mailing address

3200 PLEASANT RUN STE B
SPRINGFIELD IL
62711-6304
US

V. Phone/Fax

Practice location:
  • Phone: 312-585-8472
  • Fax: 312-585-8472
Mailing address:
  • Phone: 312-585-8472
  • Fax: 312-585-8472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH B PACKETT
Title or Position: COO
Credential:
Phone: 727-643-4714