Provider Demographics
NPI:1497839567
Name:AGEE, JEFFREY H (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:H
Last Name:AGEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:319 E MADISON ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62701
Mailing Address - Country:US
Mailing Address - Phone:217-753-9323
Mailing Address - Fax:217-753-9327
Practice Address - Street 1:319 E MADISON ST
Practice Address - Street 2:SPRINGFIELD MRI & IMAGING SUITE J
Practice Address - City:SPRINGFIELD
Practice Address - State:IL
Practice Address - Zip Code:62701
Practice Address - Country:US
Practice Address - Phone:217-528-4770
Practice Address - Fax:217-528-2154
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP08658Medicare PIN