Organization · NPI-2

Adult Internal Medicine Practice LLC

Internal Medicine · Swansea, IL

NPI number1265688238
StatusActive
Last updated in NPPESSep 6, 2021

Details

NPI
1265688238
Entity type
Organization (NPI-2)
Legal business name
Adult Internal Medicine Practice LLC
Organization subpart
No
Enumeration date
Aug 11, 2008
Certification date
Sep 6, 2021
Last updated
Sep 6, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine––Yes

Practice location

15 Park Pl
Swansea, IL 62226-2918

Phone 618-257-0780 · Fax 618-257-0715

Mailing address

15 Park Pl
Swansea, IL 62226-2918

Phone 618-257-0780 · Fax 618-355-9972

Authorized official

Charles W Ampadu
Owner
6182570780

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Internal Medicine providers in Swansea, IL