MEDICARE: KILLIAN AND ASSOCIATES SC

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	2084P0800X	Psychiatry Physician	042007661	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	:	1487642708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KILLIAN AND ASSOCIATES SC

Provider Business Mailing Address
First Line	:	3901 PINTAIL DR STE A
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-6768
Country	:	US
Telephone Number	:	217-544-3143
Fax Number	:	217-544-4436

Provider Business Practice Location Address
First Line	:	3901 PINTAIL DR STE A
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62711-6768
Country	:	US
Telephone Number	:	217-544-3143
Fax Number	:	217-544-4436

Authorized Official
Title or Position	:	OWNER
Name	:	TERRY M KILLIAN
Credential	:	MD
Telephone Number	:	217-544-3143

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	06/26/2026

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Directions to “KILLIAN AND ASSOCIATES SC ” Practice Location

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