Jacksonville, LLC

NPI #1740431345 in Jacksonville, Illinois

Provider Information

NPI Number
1740431345
Entity Type
Organization
Organization Name
Jacksonville, LLC
Primary Specialty
Family Medicine
Enumeration Date
Oct 2, 2008
Last Updated
Oct 2, 2008

Practice Location

Address
1602 W LAFAYETTE AVE
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
Internal Medicine
Nurse Practitioner
Family Medicine

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