Healthcare Provider Details
I. General information
NPI: 1235316191
Provider Name (Legal Business Name): SPRINGFIELD CLINIC, LLP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/23/2008
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
600 N MAIN ST
TAYLORVILLE IL
62568-1668
US
IV. Provider business mailing address
1025 S 6TH ST
SPRINGFIELD IL
62703-2403
US
V. Phone/Fax
- Phone: 217-287-8855
- Fax:
- Phone: 217-528-7541
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
CAL
THOMAS
Title or Position: CHIEF STRATEGY OFFICER
Credential:
Phone: 217-528-7541