# COLLABORATIVE MEDICAL PLLC

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

## Provider details

- **NPI number:** 1891494738
- **Authorized official:** DR. JAMES M CASEY DC (OWNER)
- **Authorized official phone:** (217) 473-8265

## Contact information

- **Practice address:** 1515 W WALNUT ST STE 6, JACKSONVILLE, IL 62650-1157
- **Practice address phone:** (217) 243-5313
- **Practice address fax:** (217) 243-7608
- **Mailing address:** 1515 W WALNUT ST STE 6, JACKSONVILLE, IL 62650-1157
- **Mailing address phone:** (217) 243-5313
- **Mailing address fax:** (217) 243-7608

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 261QP3300X | Pain Clinic/Center | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 02/28/2023
- **Last updated:** 08/23/2024