MEDICARE: PAMELA A CAMPBELL MD

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	036121704	IL
2	2084P0804X	Child & Adolescent Psychiatry Physician	036-121704	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	:	1679517288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA A CAMPBELL MD

Provider Business Mailing Address
First Line	:	319 E MADISON ST
Second Line	:	3RD FLOOR
City	:	SPRINGFIELD
State	:	IL
Zip	:	62701
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	319 E MADISON ST FL 3
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62701-1035
Country	:	US
Telephone Number	:	217-545-8000
Fax Number	:	217-545-2275

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	02/18/2020

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Directions to “ PAMELA A CAMPBELL MD” Practice Location

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