NPIMap

Organization Active NPI

Wabash Family Practice Center Lab

  • Clinical Medical Laboratory
  • Springfield, IL
National Provider Identifier
1346408424
Registry record updated Jul 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WABASH FAMILY PRACTICE CENTER LAB
Practice address
2200 Wabash Ave
Springfield, IL 62704-5352
Phone
(217) 528-7541
NPI assigned
May 27, 2008
Last updated
Jul 25, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SPRINGFIELD CLINIC, LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 25, 2017

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

Authorized official

Name
Mr. Alan Nerone
Title
Senior Vice President & Cfo
Phone
(217) 528-7541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

2200 Wabash Ave
Springfield, IL 62704-5352

Mailing address

1025 South 6TH Street
Springfield, IL 62703-2403
Phone (217) 528-7541

National Provider Directory

National Provider Directory
Tax ID family
John Allen Et Al PTR63 organizations share this tax ID, including this one
Part of
John Allen Et Al PTR

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

747 N Rutledge St
#2
Springfield, IL 62702

NPI Registry JSON

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500940800000",
    "number": "1346408424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 SOUTH 6TH STREET",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627032403",
            "telephone_number": "217-528-7541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 WABASH AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627045352",
            "telephone_number": "217-528-7541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WABASH FAMILY PRACTICE CENTER LAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPRINGFIELD CLINIC, LLP",
        "enumeration_date": "2008-05-27",
        "last_updated": "2017-07-25",
        "status": "A",
        "authorized_official_last_name": "NERONE",
        "authorized_official_first_name": "ALAN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT & CFO",
        "authorized_official_telephone_number": "217-528-7541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2017; 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.