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

Proactive MD Il SC

Organization Primary Care Clinic/Center · NPI 1881488773

Proactive MD Il SC is a Primary Care Clinic/Center in O Fallon, Illinois. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1472 N Green Mount Rd
O Fallon, IL 62269-3416
Phone: (730) 240-8040
Show map & directions

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

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X

Record details

NPI number1881488773
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Kemble — Cmo · (864) 501-0751
Other names Oe 520 Health Center
NPI enumeratedApril 7, 2025
Last updated in NPPESApril 7, 2025
Certification dateMarch 25, 2025
Mailing address124 Allawood Ct, Simpsonville, SC 29681-6207