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NPI 1427305473

NPI 1427305473 : SPRINGFIELD CLINIC HILLSBORO WEST LAB : HILLSBORO, IL

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General NPI Number Information
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    NPI Number           |    1427305473
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    Entity Type          |    Organization 
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    Legal Business Name  |    SPRINGFIELD CLINIC HILLSBORO WEST LAB 
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Dates
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    Enumeration Date     |    08/09/2012
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    Last Update Date     |    07/26/2017
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Provider Practice Location Address
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    Address Line         |    1280 E TREMONT ST 
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    City                 |    HILLSBORO
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    State                |    IL
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    Zip                  |    62049-1912
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    Country              |    US
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    Telephone            |    217-532-2320
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1025 S 6TH ST 
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    City                 |    SPRINGFIELD
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    State                |    IL
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    Zip                  |    62703-2403
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    Country              |    US
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    Telephone            |    217-528-7541
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    Fax                  |    
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Authorized Official
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    Title or Position    |    SENIOR VICE PRESIDENT & CFO
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    Name                 |    MR. ALAN  NERONE 
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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        |    291U00000X
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    Taxonomy Name        |    Clinical Medical Laboratory
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    License Number       |    
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    License Number State |    
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