SPRINGBOARD PEDIATRICS INC NPI 1982052585

NPI Information

NPI: 1982052585
Provider Name: SPRINGBOARD PEDIATRICS INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D2116258

Address:
2980 N MAIN ST
SUITE 2
DECATUR, IL
ZIP 62526
Phone: (217) 706-0953
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SPRINGBOARD PEDIATRICS INC is a primary care clinic center in Decatur, IL. SPRINGBOARD PEDIATRICS INC NPI is 1982052585. The provider is registered as an organization entity type.

The provider's business location address is:

2980 N MAIN ST
SUITE 2
DECATUR, IL
ZIP 62526-291
Phone: (217) 706-0953

The provider's authorized official is Martin Okpalike .
The authorized official title is President and has the following contact phone number (217) 876-8000.

The CLIA number assigned to this NPI record is 14D2116258 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2016 and was last updated on 6/21/2016.

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
1	261QP2300X	Clinic/Center	Primary Care			Yes

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

NPI Synchronization or Removal

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