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

Passavant Physician Association

Organization Family Medicine Physician · NPI 1841578507

Passavant Physician Association is a Family 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
2

Practice location Address checks out

1600 W Walnut St
Jacksonville, IL 62650-1136
Phone: (217) 245-9541
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 036098965 (IL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence 209007563 (IL)

Record details

NPI number1841578507
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stephen Lee — Plan Administrator · (217) 479-5890
Other names Wound Clinic Rhc
NPI enumeratedJuly 29, 2011
Last updated in NPPESJuly 29, 2011
Mailing address1600 W Walnut St, Jacksonville, IL 62650-1136

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