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Organization

PHYSICIANS HEALTH ASSOCIATION OF ILLINOIS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MICHAEL KOS (IPA ADMINISTRATOR)
(217) 588-2674
Entity
Organization

Contact information

Practice address
701 N 1ST ST, SPRINGFIELD, IL 62781-4026
(217) 588-2882
(217) 757-7550
Mailing address
701 N 1ST STREET, BOX 136, SPRINGFIELD, IL 62781
(217) 588-2882
(217) 757-7550

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary

Other

Enumeration date
11/17/2006
Last updated
06/30/2022
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