Unknown Individual – Obstetrics & Gynecology Physician, NPI 1164410163
Obstetrics & Gynecology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1025, South 6th Street, South Town, Springfield, Sangamon County, Illinois, 62703, United States
SPRINGFIELD, IL 627032403
Phone: (217) 528-7541
Type: Mailing
900, North 1st Street, Springfield, Sangamon County, Illinois, 62702, United States
SPRINGFIELD, IL 627023749
Phone: (217) 528-7541
Fax: (217) 525-1007
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62703)
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