Organization
CENTRAL ILLINOIS EMERGENCY PHYSICIANS, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M JOHNSON M.D. (LLP MANAGING PARTNER)
(800) 253-5358
Entity
Organization
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3810
(217) 464-2966
(217) 464-2970
Mailing address
75 REMIT DRIVE, SUITE 1707, CHICAGO, IL 60675-1707
(800) 701-3381
(239) 939-1682
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036100726
—
IL
Enumeration date
07/13/2006
Last updated
08/22/2013
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