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

Passavant Physician Association

Organization Internal Medicine Physician · NPI 1720370778

Passavant Physician Association is an Internal Medicine Physician in Jacksonville, Illinois. Licensed in Illinois. Registered with an NPI since 2011.

Licensed in
IL
In the registry since
2011
Specialties on file
3

Practice location Address checks out

559 N Westgate Ave
Jacksonville, IL 62650-1156
Phone: (217) 243-5474
Show map & directions

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

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 036091905 (IL)
Internal Medicine Physician Taxonomy 207R00000X · Licence 036056832 (IL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 209004842 (IL)

Record details

NPI number1720370778
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Lee — Manager · (217) 479-5890
Other names Passavant Internal Medicine Rural Health Clinic
NPI enumeratedMay 10, 2011
Last updated in NPPESJuly 6, 2011
Mailing address1600 W Walnut St, Jacksonville, IL 62650-1136

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