| Passavant Physician Association | |
|
559 N Westgate Ave Jacksonville IL 62650-1156 | |
| (217) 243-5474 | |
| (217) 245-2322 |
| Full Name | Passavant Physician Association |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 559 N Westgate Ave, Jacksonville, Illinois |
| Authorized Official Name and Position | Robert Ellison (DIRECTOR) |
| Authorized Official Contact | 2174795890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passavant Physician Association 559 N Westgate Ave Jacksonville IL 62650-1156 Ph: (217) 243-5474 | Passavant Physician Association 559 N Westgate Ave Jacksonville IL 62650-1156 Ph: (217) 243-5474 |
| NPI Number | 1972054609 |
|---|---|
| Provider Enumeration Date | 10/18/2016 |
| Last Update Date | 04/04/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972054609 | NPI | - | NPPES |
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