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General NPI Number Information
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NPI Number | 1518172162
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Entity Type | Organization
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Legal Business Name | SANGAMON COUNTY PAIN CENTER
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 315 CHATHAM RD STE 100
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City | SPRINGFIELD
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State | IL
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Zip | 62704-1497
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Country | US
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Telephone | 217-698-5400
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Fax | 217-698-2800
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Provider Business Mailing Address
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Address Line | 315 CHATHAM RD STE 100
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City | SPRINGFIELD
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State | IL
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Zip | 62704-1497
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Country | US
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Telephone | 217-698-5400
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Fax | 217-698-2800
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY ANDREW WINGHAM
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Credential | DC
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Telephone | 217-698-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | IL
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