Organization · Type 2 NPI

Jacksonville, LLC

Rural Health Clinic/Center · Jacksonville, IL

NPI number 1619129897 Active

Practice location

1602 W Lafayette Ave
Jacksonville, IL 62650-1007

Fax (217) 243-6165

Mailing address

PO Box 3428
Springfield, IL 62708-3428

Specialties and licenses

TaxonomyCodeLicense
Rural Health Clinic/Center Primary 261QR1300XNone listed

Rural Health Clinic/Center: Definition to come...

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About NPI 1619129897

Jacksonville, LLC's National Provider Identifier is 1619129897, issued on Oct 21, 2008. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Jacksonville, IL. The record was last updated on Oct 21, 2008.