North Dirksen Medical Associates, Llc

NPI 1063646040 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1063646040
Enumeration Date 05/06/2009
Last Updated 05/06/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name J. TRAVIS J. TRAVIS
Position VICE PRESIDENT HCNA AND OPERATIONS
Phone (217) 588-7400
Fax
Practice Location
3220 ATLANTA ST
SPRINGFIELD IL, 62707-8801, US
Phone (217) 588-7400
Fax
Business Location
PO BOX 3428
SPRINGFIELD IL, 62708-3428, US
Phone (800) 577-5368
Fax (217) 757-2021
Toxanomy
Taxonomy Code 363L00000X
License State
License Number
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According to our database, North Dirksen Medical Associates, Llc NPI is 1063646040, taxonomy code is 363L00000X North Dirksen Medical Associates, Llc physically located at 3220 Atlanta St, Springfield IL, 62707-8801. NPI Number 1033115704 has the healthcare provider type.

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1063646040 NPI number is provided on an as is basis without warranty of any kind. 1063646040 is maintained by the National Plan & Provider Enumeration System. The contents of North Dirksen Medical Associates, Llc are for informational purposes only.