Organization Active NPI

Lawrence L Jeckel MD PC

  • Psychiatry Physician
  • Champaign, IL
National Provider Identifier
1003983057
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LAWRENCE L JECKEL MD PC
Practice address
2500 Galen Drive
Champaign, IL 61821-7038
Phone
(217) 356-0228
Fax
(217) 356-0667
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lawrence Lee Jeckel, MDNPI 1831362409
Title
President
Phone
(217) 356-0228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X IL Primary

Addresses

Primary practice location

2500 Galen Drive
Champaign, IL 61821-7038

Mailing address

2500 Galen Drive
Champaign, IL 61821-7038
Phone (217) 356-0228

National Provider Directory

National Provider Directory

Locations

2500 Galen Dr
Champaign, IL 61821
Phone (217) 351-4355

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1003983057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 GALEN DRIVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618217038",
            "telephone_number": "217-356-0228",
            "fax_number": "217-356-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 GALEN DRIVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618217038",
            "telephone_number": "217-356-0228",
            "fax_number": "217-356-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCE L JECKEL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "JECKEL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-356-0228",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.