Jacksonville, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

JACKSONVILLE, LLC

Practice address

1602 W Lafayette Ave
Jacksonville, IL 62650-1007

Phone

(217) 243-7200

Fax

(217) 243-6165

NPI assigned

Oct 2, 2008

Last updated

Oct 2, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

J. Travis Dowell

Title

Vice President, Hcna and Operations

Phone

(217) 788-3342

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222905600000",
    "number": "1740431345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3428",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627083428",
            "telephone_number": "800-577-5368",
            "fax_number": "217-757-2021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 W LAFAYETTE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501007",
            "telephone_number": "217-243-7200",
            "fax_number": "217-243-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-10-02",
        "status": "A",
        "authorized_official_last_name": "DOWELL",
        "authorized_official_first_name": "J. TRAVIS",
        "authorized_official_title_or_position": "VICE PRESIDENT, HCNA AND OPERATIONS",
        "authorized_official_telephone_number": "217-788-3342"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacksonville Pediatric Associates, LLC
• Jacksonville School Dist 117
• Jacksonville, LLC (Internal Medicine Clinic of Jacksonville)
• Jacksonville, LLC (Jacksonville Family Practice)
• Jacksonville, LLC (Jacksonville Family Medical Associates)
• Carrie Elizabeth Janus, PMHNP
• Sarah B Jarman, FNP
• Jacob Jarzen, DMD
• John C Jarzen, D.D.S.
• Jeffrey L Olejnik LLC (Focus on Womens Health)

• Family Medicine Physician in Jacksonville, IL
• Providers in Jacksonville, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.