# JACKSONVILLE IL WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Jacksonville Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922682822
- **Authorized official:** MS. KATHERINE S. O'NEIL FNP (OWNER)
- **Authorized official phone:** (217) 204-8081

## Contact information

- **Practice address:** 1521 W WALNUT ST STE D, JACKSONVILLE, IL 62650-1153
- **Practice address phone:** (217) 279-5815
- **Practice address fax:** (217) 279-5816
- **Mailing address:** 1329 W COLLEGE AVE, JACKSONVILLE, IL 62650-2216
- **Mailing address phone:** (217) 204-8081

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 05/07/2021
- **Last updated:** 05/07/2021