Decatur Psychiatry Ltd
Psychiatry & Neurology, Psychiatry in Decatur, IL. Organization (NPI-2).
NPI number1770638686
StatusActive
Last updated in NPPESOct 4, 2024
Details
- NPI
- 1770638686
- Entity type
- Organization (NPI-2)
- Legal business name
- Decatur Psychiatry Ltd
- Organization subpart
- No
- Enumeration date
- Jan 24, 2007
- Certification date
- Oct 4, 2024
- Last updated
- Oct 4, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology, Psychiatry | 036105848 | IL | Yes |
Practice location
2580 E Federal Dr Ste 403Decatur, IL 62526-2189
Phone 217-809-0429 · Fax 217-422-0041
Mailing address
2580 E Federal Dr Ste 403Decatur, IL 62526-2189
Phone 217-809-0429 · Fax 217-422-0041
Authorized official
Anjum Bashir
Owner
2178090429
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All 8 Psychiatry Physician providers in Decatur · All 1,941 providers in Decatur
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