NPI 1770789778

Fairfield Estates, LLC

Organisation Point of Service Fairfield, IL

Practice location

Address: 315 North Market Street, Fairfield, IL 62837
Phone: (618) 842-5875
Fax: (618) 842-5870
Mailing address: 78 Centennial Loop, Eugene, OR 97401-7900

Authorised official

Name: John Holtz
Title: Controller
Phone: (541) 747-3373

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

Other Point of Service providers in Illinois →

Registry record

NPI: 1770789778
Entity type: Organization
NPI issued: 26 Jun 2007
Record last updated: 24 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.