Madison Park Christian Church

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

MADISON PARK CHRISTIAN CHURCH

Practice address

4700 Broadway St
Quincy, IL 62305-9112

Phone

(217) 222-2529

Fax

(217) 222-2895

NPI assigned

Dec 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Glen Charles Sackett, D. MIN.

Title

Preaching Minister

Phone

(217) 222-2529

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Evan W Horner

  • Specialist
  • Quincy, IL
  • NPI 1598982415
  NPD (past)

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

{
    "created_epoch": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1649453283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059112",
            "telephone_number": "217-222-2529",
            "fax_number": "217-222-2895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 BROADWAY ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059112",
            "telephone_number": "217-222-2529",
            "fax_number": "217-222-2895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON PARK CHRISTIAN CHURCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "SACKETT",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PREACHING MINISTER",
        "authorized_official_telephone_number": "217-222-2529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D. MIN."
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "001320049",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN HEALTH SERVICES",
            "identifier": "344905000",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Lyons, M.S. CCC-SLP
• Bethany Elizabeth Maas, RDN, LD
• Susan Rae Macdonough, LCPC
• Paula S Mackrides, D.O.
• Austin John Maddy
• Obioma Nnene Maduakor, MD
• Jessica Nicole Maggart
• Tana Maggart, MS, CCC-SLP
• Jessica Magliocco
• Maine Street Chiropractic

• Voluntary or Charitable Agency in Quincy, IL
• Providers in Quincy, IL by specialty
• Voluntary or Charitable Agency in Illinois

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