is a Psychiatry in Springfield, Illinois. practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for is 1942312079. The last update date is .
's current location address is 923 S 6th St, Springfield, Illinois. You can contact this provider via phone number 2177889999 and fax number 2177889976. The mailing address for is 923 S 6th St, Springfield, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 923 S 6th St, Springfield, Illinois |
| Phone Number | 2177889999 |
| Fax Number | 2177889976 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1942312079 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 923 S 6th St |
|---|---|
| City | Springfield |
| State | Illinois (IL) |
| Post Code | 627032401 |
| Phone Number | 2177889999 |
| Fax Number | 2177889976 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 36075498 |
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Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 36075498 | IL | -- | |
| HEALTHLINK | IL | 118064 | |
| 93972 | IL | HEALTH ALLIANCE | |
| P00159380 | IL | RAILROAD MEDICARE |
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