Healthcare Provider Details

I. General information

NPI: 1174930754
Provider Name (Legal Business Name): LINDSEY M BIRK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSEY MARIE WRIGHT

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2239 E COOK ST
SPRINGFIELD IL
62703-1944
US

IV. Provider business mailing address

2239 E COOK ST
SPRINGFIELD IL
62703-1944
US

V. Phone/Fax

Practice location:
  • Phone: 217-788-2300
  • Fax: 217-788-2342
Mailing address:
  • Phone: 217-788-2300
  • Fax: 217-788-2342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209-015903
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: