Koke Mill Medical Associates, LLC

NPI #1225289861 in Springfield, Illinois

Provider Information

NPI Number: 1225289861
Entity Type: Organization
Organization Name: Koke Mill Medical Associates, LLC
Primary Specialty: Internal Medicine
Enumeration Date: Oct 1, 2008
Last Updated: Oct 1, 2008

Practice Location

Address: 3132 OLD JACKSONVILLE RD
City: Springfield
State: Illinois
ZIP Code: 62704-7400
Phone: (217) 862-0800

Authorized Official

Name: J. TRAVIS DOWELL
Title: VICE PRESIDENT HCNA AND OPERATIONS
Phone: (217) 788-3342

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Nurse Practitioner - Family — Family	363LF0000X
Internal Medicine	207R00000X	Primary

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