Passavant Physician Association
LBN: Passavant Physician Association
Passavant Physician Association is an health care organization with primary practice located at 1600 W Walnut St , Jacksonville IL 62650-1136. The organization recently has 9 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Obstetrics, Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine, Allopathic & Osteopathic Physicians / Surgery, Speech, Language and Hearing Service Providers / Audiologist, Ambulatory Health Care Facilities / Multi-Specialty, Physician Assistants & Advanced Practice Nursing Providers / Adult Health. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Passavant Physician Association can be contacted via phone (217) 479-5890, or through Graham, Wendi D via phone (217) 479-5663.
Contact Information
Primary practice address
1600 W Walnut St
Jacksonville IL 62650-1136
Phone: (217) 479-5890
Fax: (217) 243-2206
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
| Allopathic & Osteopathic Physicians / Obstetrics | 207VX0000X | 036048526 | Illinois |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 036057937 | Illinois |
| Allopathic & Osteopathic Physicians / Undersea and Hyperbaric Medicine | 2083P0011X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | ||
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X |
Profile Details
| NPI number | 1962689307 |
|---|---|
| LBN Legal business name | Passavant Physician Association |
| DBA Doing business as | |
| Authorized official | Graham, Wendi D |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 29th, 2008 |
| Last updated | Mar 21st, 2018 - about 7 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962689307 | NPPES |
| Illinois | Other | 6932023 | BCBS |
| Illinois | Other | DH1383 | BCBS |
| Illinois | Other | IL2621 | BCBS |
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