# PHYSICIANS GROUP ASSOCIATES SC

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

## Provider details

- **NPI number:** 1366779282
- **Authorized official:** DR. JAMES LAFATA (PRESIDENT)
- **Authorized official phone:** (217) 698-9722

## Contact information

- **Practice address:** 111 N MAIN ST, NEW BERLIN, IL 62670-4593
- **Practice address phone:** (217) 488-2201
- **Practice address fax:** (217) 488-3508
- **Mailing address:** PO BOX 500, CHATHAM, IL 62629-0500
- **Mailing address phone:** (217) 670-2424
- **Mailing address fax:** (217) 670-2809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 036064159 | IL | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | 209-003289 | IL | — |

## Other

- **Enumeration date:** 11/13/2009
- **Last updated:** 07/24/2013