Organization
ILLINOIS DEPARTMENT OF PUBLIC HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC E. WHITAKER M.D., MPH (DIRECTOR)
(312) 814-5278
Entity
Organization
Contact information
Practice address
825 N RUTLEDGE ST, SPRINGFIELD, IL 62702-4910
(217) 782-6562
(217) 524-7924
Mailing address
535 W JEFFERSON ST, 5TH FLOOR, SPRINGFIELD, IL 62761-0001
(217) 782-4977
(217) 782-3987
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IL
Other
Enumeration date
04/26/2007
Last updated
08/22/2020
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