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General NPI Number Information
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NPI Number | 1053508960
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Entity Type | Organization
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Legal Business Name | SPRINGFIELD CLINIC LLP
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 501 N MAIN ST
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City | FLORA
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State | IL
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Zip | 62839-1405
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Country | US
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Telephone | 618-403-5040
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Fax | 618-403-5042
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Provider Business Mailing Address
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Address Line | PO BOX 19248
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City | SPRINGFIELD
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State | IL
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Zip | 62794-9248
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Country | US
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Telephone | 217-528-7541
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Fax | 217-528-8962
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Authorized Official
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Title or Position | CSO
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Name | CAL ROBERT THOMAS
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Credential |
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Telephone | 217-528-7541
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State | IL
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