Illinois-Indiana Em-I Medical Services S C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

ILLINOIS-INDIANA EM-I MEDICAL SERVICES S C

Practice address

812 N Logan Ave
Danville, IL 61832-3752

Phone

(217) 443-5221

Fax

(217) 443-5269

NPI assigned

Oct 21, 2008

Last updated

Jan 4, 2024By 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

Karen Vaughn

Title

Ao

Phone

(404) 450-4684

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1224547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1821240953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80175",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191011175",
            "telephone_number": "003-553-8188",
            "fax_number": "610-834-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 N LOGAN AVE",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323752",
            "telephone_number": "217-443-5221",
            "fax_number": "217-443-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS-INDIANA EM-I MEDICAL SERVICES S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-21",
        "last_updated": "2024-01-04",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "VAUGHN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "404-450-4684"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nurse Practitioner in Danville, IL
• Providers in Danville, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.