# SPRINGFIELD OB/GYN GROUP LTD

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

## Provider details

- **NPI number:** 1639359797
- **Authorized official:** MS. DIANNE R LUSINGER (OFFICE MANAGER)
- **Authorized official phone:** (815) 729-0330

## Contact information

- **Practice address:** 301 SPRINGFIELD AVE, JOLIET, IL 60435-6590
- **Practice address phone:** (815) 729-0330
- **Practice address fax:** (815) 729-0566
- **Mailing address:** 301 SPRINGFIELD AVE, JOLIET, IL 60435-6590
- **Mailing address phone:** (815) 729-0330
- **Mailing address fax:** (815) 729-0566

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | IL | Yes |

## Other

- **Enumeration date:** 11/06/2007
- **Last updated:** 03/27/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 09908558 | BCBS | IL |
| 01 | — | 1922161827 | INDIVIDUAL NPI | IL |