MEDICARE: JOINT ACTIVE SYSTEMS, INC

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	332B00000X	Durable Medical Equipment & Medical Supplies	203000238	IL
2	335E00000X	Prosthetic/Orthotic Supplier	203000238	IL
3	332BC3200X	Customized Equipment (DME)	203000238	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2571346	OTHER	IL	BLUE CROSS BLUE SHIELD IL

General Provider Information

NPI Number	:	1639172331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOINT ACTIVE SYSTEMS, INC

Provider Business Mailing Address
First Line	:	2600 S RANEY ST
Second Line	:
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-4219
Country	:	US
Telephone Number	:	217-342-3412
Fax Number	:	217-347-3384

Provider Business Practice Location Address
First Line	:	2600 S RANEY ST
Second Line	:
City	:	EFFINGHAM
State	:	IL
Zip	:	62401-4219
Country	:	US
Telephone Number	:	217-342-3412
Fax Number	:	217-347-3384

Authorized Official
Title or Position	:	INSURANCE CONTRACTS MANAGER
Name	:	REBECCA MORRIS
Credential	:
Telephone Number	:	217-342-3412

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	10/09/2025

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Directions to “JOINT ACTIVE SYSTEMS, INC ” Practice Location

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