Organization
SCAN AMERICAN SPRINGFIELD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HOHL (PRESIDENT)
(615) 599-7655
Entity
Organization
Contact information
Practice address
619 E MASON ST, ROOM 4P70, SPRINGFIELD, IL 62701-1034
(217) 528-4633
(217) 528-4631
Mailing address
800 E CARPENTER ST, PO BOX 1977, SPRINGFIELD, IL 62702-5324
(217) 544-6464
(217) 757-6021
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
081769
HEALTH ALLIANCE
IL
01
—
08432063
BLUE CROSS BLUE SHIELD
IL
01
—
3333333
UMWA
IL
01
—
516545
HEALTHLINK
IL
01
—
P00052970
RAILROAD MEDICARE
IL
Enumeration date
04/04/2006
Last updated
08/22/2020
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