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Organization
PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
Active
Organization
PASSAVANT MEMORIAL AREA HOSPITAL ASSOCIATION
Active
Other names
Jacksonville Professional Fees
Organization subpart
No
Provider details
NPI number
Authorized official
ANN BOWLING (DIRECTOR)
(217) 588-2626
Entity
Organization
Contact information
Practice address
1600 W WALNUT ST, JACKSONVILLE, IL 62650-1136
(217) 245-9541
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(217) 245-9541
(217) 757-7550
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
NULL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
2085R0001X
Radiation Oncology Physician
—
NULL
2085R0001X
Radiation Oncology Physician
—
—
208M00000X
Hospitalist Physician
—
NULL
208M00000X
Hospitalist Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
07/19/2022
Last updated
01/09/2024
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