Passavant Physician Association
NPI #1720370778 in Jacksonville, Illinois
Provider Information
- NPI Number
- 1720370778
- Entity Type
- Organization
- Organization Name
- Passavant Physician Association
- Primary Specialty
- Internal Medicine
- Enumeration Date
- May 10, 2011
- Last Updated
- Jul 6, 2011
Practice Location
- Address
- 559 N WESTGATE AVE
- City
- Jacksonville
- State
- Illinois
- ZIP Code
- 62650-1156
- Phone
- (217) 243-5474
Authorized Official
- Name
- MR. STEPHEN G LEE
- Title
- MANAGER
- Phone
- (217) 479-5890
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
| Nurse Practitioner - Adult Health — Adult Health |
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