Unknown Individual – Family Medicine Physician, NPI 1750612503
Family Medicine Physician
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
612 E ROADWAY ST
SPARTA, IL 62286
Phone: (618) 443-3234
Fax: (618) 443-3234
Type: Mailing
612, East Broadway Street, Sparta, Randolph County, Illinois, 62286, United States
SPARTA, IL 622861818
Phone: (618) 443-3234
Fax: (618) 443-3234
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)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62286)
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