Individual provider Active NPI

Steven H. Packard, M.D.

  • Orthopaedic Surgery Physician
  • Danville, IL
National Provider Identifier
1750491395
Registry record updated Jan 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
036094806 Issued in IL
Practice address
707 N Logan Ave
Danville Polyclinic, LTD.
Danville, IL 61832-4360
Phone
(217) 477-4748
Fax
(217) 444-4966
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 036094806 IL Primary

Addresses

Primary practice location

707 N Logan Ave
Danville Polyclinic, LTD.
Danville, IL 61832-4360

Mailing address

707 N Logan Ave
Danville Polyclinic, LTD.
Danville, IL 61832-4360
Phone (217) 477-4748

Other identifiers 3

IdentifierTypeStateIssuer
036094806OtherILBCBS OF ILLINOIS
036094806MedicaidIL
282792OtherHEALTH ALLIANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036094806ILMDOrthopaedic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420502400000",
    "number": "1750491395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 N LOGAN AVE",
            "address_2": "DANVILLE POLYCLINIC, LTD.",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324360",
            "telephone_number": "217-477-4748",
            "fax_number": "217-444-4966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N LOGAN AVE",
            "address_2": "DANVILLE POLYCLINIC, LTD.",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618324360",
            "telephone_number": "217-477-4748",
            "fax_number": "217-444-4966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKARD",
        "first_name": "STEVEN",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036094806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ILLINOIS",
            "identifier": "036094806",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036094806",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH ALLIANCE",
            "identifier": "282792",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2015; 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.