Organization
SPRINGFIELD RADIOLOGISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEPHEN LEE (BUSINESS MANAGER)
(217) 544-2149
Entity
Organization
Contact information
Practice address
611 N 6TH ST, SPRINGFIELD, IL 62702-5327
(217) 544-2149
(217) 544-9553
Mailing address
611 N 6TH ST, SPRINGFIELD, IL 62702-5327
(217) 544-2149
(217) 544-9553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08415052
BCBS
IL
01
—
103749
HEALTHLINK
IL
01
—
CF1100
RR MEDICARE
IL
01
—
CI7752
RRMED
IL
Enumeration date
05/10/2006
Last updated
10/15/2007
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