MEDICARE: JAMES CECIL DO

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	207V00000X	Obstetrics & Gynecology Physician	036-085396	IL
2	207V00000X	Obstetrics & Gynecology Physician	R7721	MO

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	:	1700881471
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES CECIL DO

Provider Business Mailing Address
First Line	:	834 N SEMINARY ST
Second Line	:	STE 501
City	:	GALESBURG
State	:	IL
Zip	:	61401-2852
Country	:	US
Telephone Number	:	309-343-2640
Fax Number	:	309-343-2663

Provider Business Practice Location Address
First Line	:	834 N SEMINARY ST
Second Line	:	STE 501
City	:	GALESBURG
State	:	IL
Zip	:	61401-2852
Country	:	US
Telephone Number	:	309-343-2640
Fax Number	:	309-343-2663

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	12/19/2012

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Directions to “ JAMES CECIL DO” Practice Location

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