Individual
MS. KACIE RAE ADCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3220 ATLANTA ST, SPRINGFIELD, IL 62707-8801
(217) 588-7400
(217) 588-7439
Mailing address
3220 ATLANTA ST, SPRINGFIELD, IL 62707-8801
(217) 588-7400
(217) 588-7439
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209025855
IL
363LP0200X
Pediatric Nurse Practitioner
2021026492
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041431559
RN
IL
Enumeration date
07/16/2021
Last updated
10/09/2025
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