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General NPI Number Information
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NPI Number | 1710022173
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Entity Type | Organization
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Legal Business Name | PRINCETON FAMILY PHYSICIANS, S.C.
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 530 PARK AVE E
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City | PRINCETON
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State | IL
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Zip | 61356-3901
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Country | US
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Telephone | 815-875-4531
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Fax | 815-872-1535
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Provider Business Mailing Address
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Address Line | 530 PARK AVE E
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City | PRINCETON
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State | IL
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Zip | 61356-3901
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Country | US
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Telephone | 815-875-4531
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Fax | 815-872-1535
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MADELEINE ROBINSON
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Credential |
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Telephone | 815-875-4531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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