Passavant Memorial Area Hospital

NPI #1649210444 in Jacksonville, Illinois

Provider Information

NPI Number: 1649210444
Entity Type: Organization
Organization Name: Passavant Memorial Area Hospital
Primary Specialty: Psychologist
Enumeration Date: Jun 8, 2006
Last Updated: Aug 23, 2007

Practice Location

Address: 557 N WESTGATE AVE
City: Jacksonville
State: Illinois
ZIP Code: 62650-1156
Phone: (217) 245-7275

Authorized Official

Name: LARRY RAGEL
Title: CFO/VICE PRESIDENT OF FINANCE
Phone: (217) 479-5527

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Counselor - Professional — Professional	101YP2500X
Psychiatry & Neurology - Psychiatry — Psychiatry	2084P0800X
Psychologist	103T00000X	Primary

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