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Individual

MICHAEL JASPER IGHO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-0001
(217) 788-3000
Mailing address
1715 SPARTAN DR, CHATHAM, IL 62629-8137
(217) 361-9442

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041489427
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209031001
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
291077
AZ

Other

Enumeration date
09/21/2024
Last updated
01/10/2025
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