Competitive Edge Sports Medicine
Organization Active NPI Sports Medicine (Family Medicine) Physician · Breese, IL
NPI 1104000561 · NPPES record last updated Dec 20, 2007
Key facts
- NPI
- 1104000561
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Sports Medicine (Family Medicine) Physician 207QS0010X
- Legal business name
- COMPETITIVE EDGE SPORTS MEDICINE
- Practice address
- 14160 Jamestown Rd
Breese, IL 62230 - Phone
- (618) 526-2603
- Fax
- (618) 526-1435
- NPI assigned
- Dec 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. David L Neighbors, MD
- Title
- President
- Phone
- (618) 526-2603
Practitioners 1
National Provider Directory
Locations
9431 Holy Cross Ln
Breese, IL 62230
Phone (618) 526-2603
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Family Medicine) Physician |
207QS0010X | Yes |
Addresses
Primary practice location
14160 Jamestown Rd
Breese, IL 62230
Mailing address
9431 Holy Cross LN
Breese, IL 62230-3510
Phone (618) 526-2603
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001400053 | Other | IL | BCBS |
Other providers in Breese, IL
- Cepamerica Illinois LLP
- City of Breese
- Clarkson Optometry Illinois PC
- Clinton M. Smith DC PC
- Community Link, Inc.
- Coping 4 Kids
- Kaci Cruthis
- Maribeth Detmer
- Christina R Diesen
- Anne Doll-Pollard
All providers in Breese, IL · Sports Medicine (Family Medicine) Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 20, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.