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COLLABORATIVE MEDICAL PLLC NPI 1891494738


NPI Information

NPI: 1891494738
Provider Name: COLLABORATIVE MEDICAL PLLC
Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
1515 W WALNUT ST STE 6
JACKSONVILLE, IL
ZIP 62650
Phone: (217) 243-5313
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COLLABORATIVE MEDICAL PLLC is a medical specialty clinic center in Jacksonville, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). COLLABORATIVE MEDICAL PLLC NPI is 1891494738. The provider is registered as an organization entity type.

The provider's business location address is:

1515 W WALNUT ST STE 6
JACKSONVILLE, IL
ZIP 62650-157
Phone: (217) 243-5313
Fax: (217) 243-7608

The provider's authorized official is James M Casey .
The authorized official title is Owner and has the following contact phone number (217) 473-8265.

The enumeration date for this NPI number is 2/28/2023 and was last updated on 2/28/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP3300XClinic/CenterPainNo
2363L00000XNurse PractitionerNo
3261QM2500XClinic/CenterMedical SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.