| Fort Health Medical Group Pa | |
|
600 S 2nd St Ste 404 Springfield IL 62704-2542 | |
| (201) 208-2616 | |
| (973) 381-5773 |
| Full Name | Fort Health Medical Group Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Child & Adolescent Psychiatry |
| Location | 600 S 2nd St Ste 404, Springfield, Illinois |
| Authorized Official Name and Position | Traci Crosby (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2015034815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Health Medical Group Pa 613 Washington Blvd # 1297 Jersey City NJ 07310-2900 Ph: (201) 208-2616 | Fort Health Medical Group Pa 600 S 2nd St Ste 404 Springfield IL 62704-2542 Ph: (201) 208-2616 |
| NPI Number | 1972342046 |
|---|---|
| Provider Enumeration Date | 05/20/2024 |
| Last Update Date | 03/26/2025 |
| Certification Date | 03/26/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972342046 | NPI | - | NPPES |
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