Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Family Medical Clinic PLLC

Organization Family Medicine Physician · NPI 1477019909

Family Medical Clinic PLLC is a Family Medicine Physician in O Fallon, Illinois. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1480 N Green Mount Rd Ste 200
O Fallon, IL 62269-3466
Phone: (618) 622-3450
Fax: (618) 622-3468
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Family Medicine Physician Taxonomy 207Q00000X

Record details

NPI number1477019909
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jacqueline Mudd — Authorized Official · (217) 324-1100
NPI enumeratedFebruary 20, 2019
Last updated in NPPESJuly 2, 2020
Certification dateJuly 2, 2020
Mailing addressPo Box 483, Litchfield, IL 62056-0483

Other providers in O Fallon