# HUMPHREYS MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SHOAL CREEK ORTHOPAEDICS
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851586192
- **Authorized official:** DR. AARON HUMPHREYS M.D. (OWNER)
- **Authorized official phone:** (217) 324-8798

## Contact information

- **Practice address:** 725 SAINT FRANCIS WAY, LITCHFIELD, IL 62056-1780
- **Practice address phone:** (217) 324-8798
- **Practice address fax:** (217) 324-8622
- **Mailing address:** 801 E CARPENTER ST, PO BOX 1977, SPRINGFIELD, IL 62702-5323
- **Mailing address phone:** (217) 544-6464
- **Mailing address fax:** (217) 757-6021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 0361131128 | IL | Yes |

## Other

- **Enumeration date:** 09/10/2007
- **Last updated:** 01/22/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 321461 | PCH GROUP \# | — |