| Passavant Physician Association | |
|
1600 W Walnut St Jacksonville IL 62650-1136 | |
| (217) 479-5890 | |
| (217) 243-2206 |
| Full Name | Passavant Physician Association |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1600 W Walnut St, Jacksonville, Illinois |
| Authorized Official Name and Position | Wendi D Graham (PRACTICE PLAN ADMINISTRATOR) |
| Authorized Official Contact | 2174795663 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passavant Physician Association 1600 W Walnut St Jacksonville IL 62650-1136 Ph: (217) 479-5890 | Passavant Physician Association 1600 W Walnut St Jacksonville IL 62650-1136 Ph: (217) 479-5890 |
| NPI Number | 1962689307 |
|---|---|
| Provider Enumeration Date | 01/29/2008 |
| Last Update Date | 03/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962689307 | NPI | - | NPPES |
| 6932023 | Other | IL | BCBS |
| DH1383 | Other | IL | RAILROAD PTAN |
| IL2621 | Other | IL | 2ND LOCATION MEDICARE PIN # |
Jacksonville Pediatric Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 W Walnut St, Jacksonville, IL 62650 Phone: 217-245-5437 Fax: 217-243-3113 | |
Siu Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 N Westgate Ave, Jacksonville, IL 62650 Phone: 217-243-8455 | |
Central Illinois Snf Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1517 W Walnut St, Jacksonville, IL 62650 Phone: 630-336-5620 | |
Springfield Clinic Jacksonville Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1000 W Morton Ave, Jacksonville, IL 62650 Phone: 217-243-6520 | |
Memorial Physician Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1602 W Lafayette Ave, Jacksonville, IL 62650 Phone: 217-243-7200 Fax: 217-243-6165 | |
Jacksonville Family Medical Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1602 W Lafayette Ave, Jacksonville, IL 62650 Phone: 217-243-7200 Fax: 217-243-6165 | |
Memorial Physician Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1600 W Walnut St, East Wing, 3rd Floor, Jacksonville, IL 62650 Phone: 217-245-5437 Fax: 217-243-3113 |