Organization
MID AMERICA EMERGENCY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ELLEN O'BRIEN ATWOOD PA-C (PHYSICIAN ASSISTANT)
(618) 530-1950
Entity
Organization
Contact information
Practice address
700 N FIRST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3156
(217) 788-6459
Mailing address
300 N PARK AVE APT A, SPRINGFIELD, IL 62702-6401
(618) 530-1950
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
085005966
IL
Other
Enumeration date
09/21/2016
Last updated
09/21/2016
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