JACKSONVILLE IL WELLNESS – NPI #1922682822
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

Health Care Provider Taxonomy Code for Clinic/Center

JACKSONVILLE IL WELLNESS is an AHC clinic located in JACKSONVILLE, IL. NPPES has assigned the NPI number 1922682822 to JACKSONVILLE IL WELLNESS on May 07, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QM2500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Medical Specialty

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACKSONVILLE IL WELLNESS below.

NPI Profile for
JACKSONVILLE IL WELLNESS

NPI Number
1922682822
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
JACKSONVILLE IL WELLNESS
Primary location
1521 W WALNUT ST STE D
JACKSONVILLE, IL 62650-1153
Phone: (217) 279-5815 Fax: (217) 279-5816
1 Other location(s):
220 E Morgan St
Jacksonville, IL 62650-2509
Phone: (217) 279-5815
Fax: (217) 279-5816
Mailing address
1329 W COLLEGE AVE
JACKSONVILLE, IL 62650-2216
Phone: (217) 204-8081 Fax:
Organization Subpart
No
Authorized Official
KATHERINE O'NEIL
OWNER
Phone: (217) 204-8081
Updated
Certification Date
May 07, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM2500X
- Clinic/Center / Medical Specialty (Primary)
363LF0000X
- Nurse Practitioner / Family
207Q00000X
- Family Medicine

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.