Organization
ASSOCIATED PATHOLOGISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHAD DEFRAIN M.D. (PRESIDENT)
(217) 220-2068
Entity
Organization
Contact information
Practice address
800 E. CARPENTER ST., SPRINGFIELD, IL 62769-0001
(217) 814-4120
Mailing address
PO BOX 10200, PEORIA, IL 61612-0200
(877) 852-4669
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011112
HEALTH ALLIANCE
IL
01
—
020102500
BLACK LUNG
IL
01
—
32017
PERSONAL CARE
IL
01
—
684895
HEALTHLINK
IL
01
—
C12333
RAILROAD MEDICARE
IL
Enumeration date
06/08/2006
Last updated
07/26/2023
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