OB PRACTICE, LLC – NPI #1629386586
Obstetrics & Gynecology

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

OB PRACTICE, LLC is a provider located in BELLEVILLE, IL. NPPES has assigned the NPI number 1629386586 to OB PRACTICE, LLC on September 14, 2010. 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 207V00000X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology.

The NPI profile was previously updated about 4 years ago on Jul 21, 2022. 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 OB PRACTICE, LLC below.

NPI Profile for
OB PRACTICE, LLC

NPI Number
1629386586
Enumeration Date

(about 16 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
OB PRACTICE, LLC
Primary location
4600 MEMORIAL DRIVE
STE. 400
BELLEVILLE, IL 62226
Phone: (618) 234-2390 Fax: (618) 234-9936
1 Other location(s):
4600 Memorial Dr Ste 240
Belleville, IL 62226-5363
Phone: (618) 234-2390
Fax: (618) 234-9936
Mailing address
4500 MEMORIAL DR
MEDICAL AFFAIRS CREDENTIALING DEPARTMENT
BELLEVILLE, IL 62226-5360
Phone: (618) 257-4644 Fax: (618) 257-6946
Organization Subpart
Yes - OB PRACTICE, LLC is subpart of another organization.
Authorized Official
JAMES DAVIS
EXECUTIVE DIRECTOR
Phone: (618) 257-4644
Updated
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
207V00000X
- Obstetrics & Gynecology (Primary)
207VG0400X
- Obstetrics & Gynecology / Gynecology

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.