Organization
ILLINOIS-INDIANA EM-I MEDICAL SERVICES S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN MARIE VAUGHN (AO)
(404) 450-4684
Entity
Organization
Contact information
Practice address
1400 W PARK ST, URBANA, IL 61801-2334
(217) 337-2000
(217) 337-2930
Mailing address
PO BOX 80175, PHILADELPHIA, PA 19101-1175
(003) 553-8188
(610) 834-9292
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
363A00000X
Physician Assistant
—
IL
363L00000X
Nurse Practitioner
Primary
—
IL
Other
Enumeration date
10/21/2008
Last updated
01/04/2024
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