# MID AMERICA EMERGENCY MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063960870
- **Authorized official:** MISS ELLEN O'BRIEN ATWOOD PA-C (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (618) 530-1950

## Contact information

- **Practice address:** 700 N FIRST ST, SPRINGFIELD, IL 62781-0001
- **Practice address phone:** (217) 788-3156
- **Practice address fax:** (217) 788-6459
- **Mailing address:** 300 N PARK AVE APT A, SPRINGFIELD, IL 62702-6401
- **Mailing address phone:** (618) 530-1950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 085005966 | IL | Yes |

## Other

- **Enumeration date:** 09/21/2016
- **Last updated:** 09/21/2016