Central Illinois Health Associates, Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Legal business name

CENTRAL ILLINOIS HEALTH ASSOCIATES, INC

Practice address

2300 N. Edward Street
Decatur, IL 62526

Phone

(217) 877-6020

Fax

(217) 873-6029

NPI assigned

Aug 18, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Marshall F. Brustein, M.D.

Title

Chairman

Phone

(217) 872-8204

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408320000000",
    "number": "1487053369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N. EDWARD STREET",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-877-6020",
            "fax_number": "217-873-6029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N. EDWARD STREET",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-877-6020",
            "fax_number": "217-873-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL ILLINOIS HEALTH ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-18",
        "last_updated": "2014-08-18",
        "status": "A",
        "authorized_official_last_name": "BRUSTEIN",
        "authorized_official_first_name": "MARSHALL",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "217-872-8204",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Preferred Provider Organization in Decatur, IL
• Providers in Decatur, IL by specialty
• Preferred Provider Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2014; 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.