Jacksonville, LLC
NPI #1619129897 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1619129897
- Entity Type
- Organization
- Organization Name
- Jacksonville, LLC
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Oct 21, 2008
- Last Updated
- Oct 21, 2008
Practice Location
- Address
- 1602 W LAFAYETTE AVE
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-1007
- Phone
- (217) 243-7200
Authorized Official
- Name
- J. TRAVIS DOWELL
- Title
- VICE PRESIDENT, HCNA AND OPERATIONS
- Phone
- (217) 788-3342
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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