Active NPI 1972522720 Individual Practitioner Male Practitioner

Dr. Daniel Lange , MD

Urology • Springfield, IL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Daniel Lange, MD is a certified Urology practicing in Springfield, IL. With approximately 29 years of clinical experience since graduating from Southern Illinois University School Of Medicine in 1997, Dr. Lange delivers high-quality medical care to the local community at 800 N 1ST ST.

Dr. Lange is affiliated with Springfield Clinic, Llp and accepts Medicare assignment.

Frequently performed procedures and clinical services include automated urinalysis test, ultrasound measurement of bladder capacity after voiding, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

800 N 1st St

Springfield, IL 627023778

Telephone 1725287541

Associated Practice Facility / Clinic

🏢 Springfield Clinic, Llp Facility NPI 1316123284

Medicare Profile & Education

Medical School

Southern Illinois University School Of Medicine

Graduation Year

1997

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Urology in Springfield, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

29 Yrs +9.1 yrs vs City Avg

City Avg: 19.9 Yrs

State Avg: 26.7 Yrs

Regional Practice Density

37 Specialists

Practicing in Springfield, IL (663 Statewide)

Telehealth Adoption Rate

18.9% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

85.7% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Lange (29 Years) 29 Yrs

Springfield Specialty Average (19.9 Years) 19.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81003 Automated urinalysis test	252	193	$19.00	$2.20
51798 Ultrasound measurement of bladder capacity after voiding	165	128	$96.00	$10.18
99213 Established patient office or other outpatient visit, typically 15 minutes	151	127	$413.83	$86.76
52000 Diagnostic exam of bladder and urethra using an endoscope	130	104	$871.58	$215.97
36415 Insertion of needle into vein for collection of blood sample	104	82	$8.25	$7.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	91	86	$583.85	$122.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	62	62	$258.81	$53.25
J0696 Injection, ceftriaxone sodium, per 250 mg	48	12	$36.00	$0.46
52332 Insertion of stent in urinary duct (ureter) using an endoscope	42	35	$2512.79	$115.34
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	32	30	$1429.31	$298.49
51705 Removal of skin suture with change of bladder tube	28	13	$458.00	$91.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	21	21	$775.57	$149.45
52356 Crushing of stone of ureter with insertion of stent using an endoscope	20	19	$2213.00	$403.03
51702 Simple insertion of temporary bladder tube	18	14	$382.00	$58.02
87077 Bacterial culture for aerobic isolates	18	15	$108.00	$7.92
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	15	15	$70.00	$15.89
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	15	15	$5219.00	$707.92
55700 Biopsy of prostate gland	14	14	$951.00	$227.37
50590 Shock wave crushing of kidney stones	13	11	$4751.38	$536.45
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	13	12	$52.92	$13.47
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	12	12	$1071.00	$54.30

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81001 Manual urinalysis test with examination using microscope, automated	415	258	$26.00	$3.11
51798 Ultrasound measurement of bladder capacity after voiding	168	126	$96.00	$9.86
99213 Established patient office or other outpatient visit, typically 15 minutes	126	111	$382.00	$86.67
36415 Insertion of needle into vein for collection of blood sample	118	91	$6.00	$5.88
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	115	99	$555.00	$122.84
52000 Diagnostic exam of bladder and urethra using an endoscope	94	79	$803.70	$226.30
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	76	55	$103.00	$8.48
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	65	61	$240.00	$53.61
52332 Insertion of stent in urinary duct (ureter) using an endoscope	65	56	$2458.38	$113.40
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	51	50	$1371.37	$302.98
51702 Simple insertion of temporary bladder tube	39	26	$382.00	$58.18
87077 Bacterial culture for aerobic isolates	31	25	$108.00	$7.92
51705 Removal of skin suture with change of bladder tube	31	11	$458.00	$89.43
52356 Crushing of stone of ureter with insertion of stent using an endoscope	26	26	$2298.12	$411.40
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	11	$50.00	$13.39
52352 Removal or manipulation of stone in ureter or kidney using an endoscope	19	19	$4135.00	$319.33
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	17	17	$5065.50	$710.48
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	14	13	$2482.00	$280.44
52240 Destruction and/or removal of large growth of bladder using an endoscope	14	12	$3466.00	$380.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$741.00	$160.70
52204 Biopsy of the bladder using an endoscope	11	11	$2019.00	$107.25

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81001 Manual urinalysis test with examination using microscope, automated	616	347	$26.00	$3.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	211	175	$497.12	$123.59
51798 Ultrasound measurement of bladder capacity after voiding	194	151	$96.00	$9.78
52000 Diagnostic exam of bladder and urethra using an endoscope	132	119	$777.42	$234.61
36415 Insertion of needle into vein for collection of blood sample	110	85	$6.00	$2.96
99213 Established patient office or other outpatient visit, typically 15 minutes	97	88	$340.47	$88.00
51702 Simple insertion of temporary bladder tube	44	28	$382.00	$59.94
52332 Insertion of stent in urinary duct (ureter) using an endoscope	41	37	$2617.68	$116.21
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	34	32	$1337.15	$311.46
51705 Removal of skin suture with change of bladder tube	26	15	$458.00	$93.76
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	26	22	$103.00	$8.51
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	24	24	$5219.00	$693.70
52356 Crushing of stone of ureter with insertion of stent using an endoscope	23	22	$2237.05	$409.10
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	22	$218.18	$54.54
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	22	12	$48.86	$13.71
87077 Bacterial culture for aerobic isolates	16	12	$108.00	$7.93
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	16	15	$1597.50	$306.43
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$646.00	$163.58
52204 Biopsy of the bladder using an endoscope	14	13	$2019.00	$119.92
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	13	13	$975.69	$29.74
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	12	12	$2482.00	$276.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	331	265	$25.85	$3.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	207	191	$321.38	$125.40
52000 Diagnostic exam of bladder and urethra using an endoscope	135	118	$930.15	$225.08
81001 Manual urinalysis test with examination using microscope, automated	125	103	$26.00	$3.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	116	103	$117.66	$53.90
99213 Established patient office or other outpatient visit, typically 15 minutes	112	105	$184.86	$89.26
81003 Automated urinalysis test	99	96	$13.00	$2.24
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	87	16	$2916.59	$201.00
51798 Ultrasound measurement of bladder capacity after voiding	82	75	$67.39	$9.64
51702 Simple insertion of temporary bladder tube	60	24	$306.03	$61.51
J1580 Injection, garamycin, gentamicin, up to 80 mg	42	12	$13.00	$1.80
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	36	20	$154.67	$31.00
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$464.51	$165.13
74420 Imaging of urinary tract	33	22	$158.00	$24.70
51741 Electronic assessment of bladder emptying	31	31	$222.77	$8.27
52332 Insertion of stent in urinary duct (ureter) using an endoscope	30	25	$2231.67	$101.49
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	29	28	$1365.83	$304.19
51705 Removal of skin suture with change of bladder tube	22	12	$460.50	$94.81
87186 Evaluation of antimicrobial drug (antibiotic, antifungal, antiviral), microdilution or agar dilution	21	15	$103.00	$8.65
36415 Insertion of needle into vein for collection of blood sample	20	19	$7.05	$3.00
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	19	18	$441.16	$171.45
99211 Office or other outpatient visit for the evaluation and management of established patient that may not require presence of healthcare professional	18	15	$54.00	$21.65
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	16	$2154.18	$416.47
52601 Electro-removal of prostate through bladder canal (urethra) with control of bleeding using an endoscope	13	13	$4283.00	$714.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	512	344	$26.00	$3.46
99213 Established patient office or other outpatient visit, typically 15 minutes	277	220	$161.67	$72.18
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	137	129	$254.34	$105.32
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	122	13	$2977.00	$223.76
52000 Diagnostic exam of bladder and urethra using an endoscope	108	88	$929.67	$200.77
51798 Ultrasound measurement of bladder capacity after voiding	78	66	$55.54	$9.66
74420 Imaging of urinary tract	47	33	$158.00	$24.69
51741 Electronic assessment of bladder emptying	40	36	$211.85	$8.57
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	37	37	$382.22	$155.14
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	34	13	$149.88	$30.04
52332 Insertion of stent in urinary duct (ureter) using an endoscope	29	26	$2199.41	$119.45
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	23	23	$1317.09	$284.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	21	$105.82	$43.70
52005 Insertion of tube into ureter using an endoscope through bladder area	21	11	$1345.10	$80.01
81003 Automated urinalysis test	18	17	$13.00	$2.25
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	18	15	$346.00	$143.45
51702 Simple insertion of temporary bladder tube	16	11	$292.06	$59.52
55700 Biopsy of prostate gland	13	13	$1185.92	$134.70
52356 Crushing of stone of ureter with insertion of stent using an endoscope	13	13	$2361.38	$420.02
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$251.67	$105.47
99442 Telephone medical discussion with physician, 11-20 minutes	12	12	$121.00	$73.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	571	348	$25.24	$3.41
99213 Established patient office or other outpatient visit, typically 15 minutes	351	255	$153.74	$71.74
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	139	116	$241.52	$103.48
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	117	13	$2977.00	$225.91
52000 Diagnostic exam of bladder and urethra using an endoscope	97	78	$782.22	$181.91
51720 Instillation of anti-cancer drug into bladder	83	13	$391.20	$81.19
74420 Imaging of urinary tract	72	40	$116.75	$25.49
51798 Ultrasound measurement of bladder capacity after voiding	67	57	$67.67	$11.85
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	40	36	$98.00	$42.93
52332 Insertion of stent in urinary duct (ureter) using an endoscope	40	32	$2441.30	$114.58
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	37	14	$144.95	$29.00
51741 Electronic assessment of bladder emptying	34	32	$210.29	$7.98
J1580 Injection, garamycin, gentamicin, up to 80 mg	32	12	$15.00	$1.79
52005 Insertion of tube into ureter using an endoscope through bladder area	31	17	$1242.32	$90.02
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	28	27	$1156.07	$261.76
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	24	24	$369.38	$160.25
52356 Crushing of stone of ureter with insertion of stent using an endoscope	20	20	$2177.20	$404.62
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	19	19	$241.84	$105.00
99221 Initial hospital inpatient care per day, typically 30 minutes	14	14	$250.00	$100.67
52235 Destruction and/or removal of growth of bladder and urethra using an endoscope, 2.0-5.0 cm	11	11	$1390.27	$293.58

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	624	365	$25.00	$3.40
99213 Established patient office or other outpatient visit, typically 15 minutes	351	250	$148.27	$69.84
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	145	123	$235.14	$103.61
52000 Diagnostic exam of bladder and urethra using an endoscope	101	77	$734.21	$158.88
J9217 Leuprolide acetate (for depot suspension), 7.5 mg	101	12	$2791.97	$213.34
51798 Ultrasound measurement of bladder capacity after voiding	86	68	$81.03	$14.77
J1580 Injection, garamycin, gentamicin, up to 80 mg	80	26	$15.00	$1.42
J2250 Injection, midazolam hydrochloride, per 1 mg	79	11	$15.00	$0.12
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	76	64	$94.75	$42.19
74420 Imaging of urinary tract	56	40	$102.57	$17.42
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	50	50	$238.12	$103.65
51741 Electronic assessment of bladder emptying	42	38	$206.67	$7.86
52332 Insertion of stent in urinary duct (ureter) using an endoscope	39	32	$2443.62	$115.16
50684 Injection of urinary duct (ureter) for X-ray imaging	35	29	$548.74	$27.43
96402 Administration of hormonal anti-neoplastic chemotherapy under skin or into muscle	31	12	$147.87	$28.97
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	30	25	$1101.40	$240.20
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	30	30	$361.70	$161.04
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	25	21	$50.56	$19.47
52356 Crushing of stone of ureter with insertion of stent using an endoscope	19	17	$1966.11	$408.93
81003 Automated urinalysis test	18	18	$13.00	$2.71
50590 Shock wave crushing of kidney stones	15	14	$3309.00	$575.26
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	14	12	$399.00	$57.67
51702 Simple insertion of temporary bladder tube	14	13	$281.00	$57.94
76872 Ultrasound scan of pelvic region through rectum	13	12	$531.69	$91.81
51728 Complex measurement of pressure of urine flow in bladder with voiding pressure studies	12	12	$1389.00	$304.24
51797 Insertion of device into abdomen with pressure and urine flow rate study	12	12	$494.75	$108.49
51784 Non-needle measurement and recording of electrical activity of muscles at bladder and bowel openings	12	12	$493.25	$33.66
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	11	11	$302.00	$48.55
J7120 Ringers lactate infusion, up to 1000 cc	11	11	$15.00	$2.59
55700 Biopsy of prostate gland	11	11	$1101.00	$240.61
J3010 Injection, fentanyl citrate, 0.1 mg	11	11	$15.00	$0.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
81002 Urinalysis, manual test	646	355	$24.26	$3.43
99213 Established patient office or other outpatient visit, typically 15 minutes	286	211	$143.29	$67.55
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	223	174	$228.04	$98.96
J2250 Injection, midazolam hydrochloride, per 1 mg	117	17	$15.00	$0.12
51798 Ultrasound measurement of bladder capacity after voiding	106	89	$79.94	$17.46
52000 Diagnostic exam of bladder and urethra using an endoscope	104	78	$842.46	$152.66
J1580 Injection, garamycin, gentamicin, up to 80 mg	70	25	$15.00	$1.45
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	51	51	$231.78	$99.62
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$354.70	$152.42
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	49	43	$92.29	$39.75
74420 Imaging of urinary tract	48	38	$99.75	$16.64
50684 Injection of urinary duct (ureter) for X-ray imaging	45	35	$502.67	$25.51
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	42	23	$48.24	$20.33
51741 Electronic assessment of bladder emptying	38	34	$205.00	$8.37
52332 Insertion of stent in urinary duct (ureter) using an endoscope	33	27	$2315.36	$113.74
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	23	21	$309.17	$126.48
52310 Simple removal of foreign body, stone, or stent in urethra or bladder using an endoscope	20	19	$1062.30	$229.35
76872 Ultrasound scan of pelvic region through rectum	19	19	$508.26	$86.97
J3010 Injection, fentanyl citrate, 0.1 mg	18	18	$15.00	$0.45
55700 Biopsy of prostate gland	18	18	$977.33	$221.63
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	18	18	$393.56	$55.99
99152 Moderate sedation services by physician also performing a procedure, patient 5 years of age or older, first 15 minutes	18	18	$244.44	$46.25
81003 Automated urinalysis test	18	18	$13.00	$3.02
36415 Insertion of needle into vein for collection of blood sample	17	17	$26.29	$2.94
52356 Crushing of stone of ureter with insertion of stent using an endoscope	17	15	$1904.41	$385.96
50590 Shock wave crushing of kidney stones	14	12	$3191.21	$553.67
99221 Initial hospital inpatient care per day, typically 30 minutes	12	12	$241.25	$97.57

Medical Specialties & State Licenses

CMS Verified: 2021-11-29

Urology Primary Specialty

NUCC Taxonomy Code: 208800000X

State License IL 036106192

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Railroad

340020547 (IL)

Commercial Insurance / Payer ID Medicare Group Ptan

IL2613 (IL)

Hospital & Practice Group Affiliations

Physical Therapist Assistant

Lauren Ray , PA-C

Physician Assistant

NPI 1033621594

Physician Assistant (Certified)

David Purves , PA

Physician Assistant - Surgical

NPI 1043405608

Physician Assistant

Dr. Trenton Wiseman , DPT

Physical Therapist

NPI 1053890392

Doctor of Physical Therapy

Ashley Rees , APRN

Nurse Practitioner - Family

NPI 1063977627

Advanced Practice Registered Nurse

Dr. Ashley Goetze , PT, DPT

Physical Therapist

NPI 1104139864

Physical Therapist, Doctor of Physical Therapy

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location November 29, 2021

Registered at 800 N 1ST ST, SPRINGFIELD, IL 627023778 (Tel: 1725287541)

📍

Updated Business Mailing Address November 29, 2021

Registered at 1025 S 6TH ST, SPRINGFIELD, IL 627032499 (Tel: 2175287541)

✅

NPI Profile Active August 19, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location August 19, 2011

Registered at 1701 E COLLEGE AVE, BLOOMINGTON, IL 617042101 (Tel: 3096643038)

📍

Updated Business Mailing Address August 19, 2011

Registered at 602 W UNIVERSITY AVE, URBANA, IL 618012530 (Tel: 2173833311)

👤

Provider Name / Credentials Updated August 19, 2011

Recorded as DANIEL LANGE, M.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 19, 2011

Urology (License #036106192 in IL)

🟢

Initial NPI Registration & Enumeration July 19, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

No patient reviews submitted yet for Dr. Daniel Lange. Be the first to share your experience!

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1972522720

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: July 19, 2006

Last Update: November 29, 2021

Sole Proprietor: No

Update or Correct Profile

Mailing Address

1025 S 6th St

Springfield, IL 627032499

Phone: 2175287541

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.