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 1972054609

Passavant Physician Association is a Family Medicine Physician in Jacksonville, Illinois. Registered with an NPI since 2016.

In the registry since
2016
Specialties on file
4

Practice location Address checks out

559 N Westgate Ave
Jacksonville, IL 62650-1156
Phone: (217) 243-5474
Fax: (217) 245-2322
Show map & directions

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

Specialties & licences

Rural Health Clinic/Center (primary) Taxonomy 261QR1300X
Family Medicine Physician Taxonomy 207Q00000X
Internal Medicine Physician Taxonomy 207R00000X
Otolaryngology Physician Taxonomy 207Y00000X

Record details

NPI number1972054609
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationPassavant Memorial Area Hospital
Authorized official Robert Ellison — Director · (217) 479-5890
NPI enumeratedOctober 18, 2016
Last updated in NPPESApril 4, 2017
Mailing address559 N Westgate Ave, Jacksonville, IL 62650-1156

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