MEDICARE: DR. TARA JEAN RAMSEY M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	036113831	IL
2	207R00000X	Internal Medicine Physician	036113831	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013980101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TARA JEAN RAMSEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 3428
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62708-3428
Country	:	US
Telephone Number	:	800-577-5368
Fax Number	:	217-757-2021

Provider Business Practice Location Address
First Line	:	1606 W LAFAYETTE AVE
Second Line	:	SUITE D
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-3707
Country	:	US
Telephone Number	:	217-479-0290
Fax Number	:	217-479-0292

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	06/07/2019

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