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NPI Code Detail

MEDICARE: JEFFREY V SWEARINGEN MD

MEDICARE: JEFFREY V SWEARINGEN 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
1207Q00000XFamily Medicine Physician036066504IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1080042557OTHERILRAIL ROAD

General Provider Information

NPI Number : 1689785305
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY V SWEARINGEN MD
Provider Business Mailing Address
First Line : 611 W. PARK ST.
Second Line : BWPC
City : URBANA
State : IL
Zip : 61801-2500
Country : US
Telephone Number : 217-383-6792
Fax Number : 217-383-4752
Provider Business Practice Location Address
First Line : 1818 E WINDSOR RD
Second Line : FAMILY MEDICINE
City : URBANA
State : IL
Zip : 61802-9566
Country : US
Telephone Number : 217-255-9670
Fax Number : 217-255-9724
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 05/14/2014

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