Jacksonville, LLC
Organization Active NPI Rural Health Clinic/Center · Jacksonville, IL
NPI 1528210705 · NPPES record last updated Oct 21, 2008
Key facts
- NPI
- 1528210705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- JACKSONVILLE, LLC
- Practice address
- 800 W State St
Jacksonville, IL 62650-2290 - Phone
- (217) 243-9471
- Fax
- (217) 243-5359
- NPI assigned
- Oct 21, 2008
- Organization subpart
- No
Authorized official
- Name
- J. Travis Dowell
- Title
- Vice President, Hcna and Operations
- Phone
- (217) 788-3342
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Memorial Physician Services
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
800 W State St
Jacksonville, IL 62650-2290
Mailing address
PO Box 3428
Springfield, IL 62708-3428
Phone (800) 577-5368
Other names
- Jacksonville Family Practice
Other providers in Jacksonville, IL
- Jacksonville Oncology Institute Limited
- Jacksonville Pediatric Associates, LLC
- Jacksonville Pediatric Associates, LLC
- Jacksonville School Dist 117
- Jacksonville, LLC
- Jacksonville, LLC
- Jacksonville, LLC
- Carrie Elizabeth Janus
- Sarah B Jarman
- Jacob Jarzen
All providers in Jacksonville, IL · Rural Health Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2008. 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.