MEDICARE: REGIONAL FAMILY HEALTH CENTER

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1356446652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL FAMILY HEALTH CENTER

Provider Business Mailing Address
First Line	:	125 W SOUTH ST
Second Line	:	SUITE 12
City	:	KEWANEE
State	:	IL
Zip	:	61443-3715
Country	:	US
Telephone Number	:	309-853-3677
Fax Number	:	309-853-3692

Provider Business Practice Location Address
First Line	:	125 W SOUTH ST
Second Line	:	SUITE 12
City	:	KEWANEE
State	:	IL
Zip	:	61443-3715
Country	:	US
Telephone Number	:	309-853-3677
Fax Number	:	309-853-3692

Authorized Official
Title or Position	:	CEO
Name	:	DR. KEVIN JEFFRIES
Credential	:	M.D.
Telephone Number	:	309-932-3101

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	04/20/2008

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Directions to “REGIONAL FAMILY HEALTH CENTER ” Practice Location

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