Provider Demographics
NPI:1073228664
Name:SPRINGFIELD CLINIC LLP
Entity Type:Organization
Organization Name:SPRINGFIELD CLINIC LLP
Other - Org Name:SPRINGFIELD CLINIC JACKSONVILLE URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF DEVELOPMENT OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CAL
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-528-7541
Mailing Address - Street 1:PO BOX 19248
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62794-9248
Mailing Address - Country:US
Mailing Address - Phone:175-287-5412
Mailing Address - Fax:
Practice Address - Street 1:1000 W MORTON AVE
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-3152
Practice Address - Country:US
Practice Address - Phone:217-243-6520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health