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NPI Code Detail

MEDICARE: SPRINGFIELD CLINIC LLP

MEDICARE: SPRINGFIELD CLINIC LLP
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
1332900000XNon-Pharmacy Dispensing Site

General Provider Information

NPI Number : 1124531082
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPRINGFIELD CLINIC LLP
Provider Business Mailing Address
First Line : 1025 S 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-2403
Country : US
Telephone Number : 217-528-7541
Fax Number :
Provider Business Practice Location Address
First Line : 1000 W MORTON AVE
Second Line :
City : JACKSONVILLE
State : IL
Zip : 62650-3152
Country : US
Telephone Number : 217-528-7541
Fax Number :
Authorized Official
Title or Position : SVP & CHIEF FINANCIAL OFFICER
Name : MR. MARK J. KUHN
Credential :
Telephone Number : 217-528-7541
Provider Enumeration Date : 11/14/2017
Last Update Date : 11/14/2017

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Directions to “SPRINGFIELD CLINIC LLP ” Practice Location

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