OrganizationActive
Jacksonville, LLC
NPI 1740431345 · Family Medicine Physician · Jacksonville, IL
Provider details
- NPI number
- 1740431345
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- J. Travis Dowell, Vice President, Hcna and Operations(217) 788-3342
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1602 W Lafayette Ave
Jacksonville, IL 62650-1007
Phone: (217) 243-7200
Fax: (217) 243-6165
Street-level locationGet directions
Mailing address
Po Box 3428
Springfield, IL 62708-3428
Registry dates
- Enumerated
- 2008-10-02
- Last updated
- 2008-10-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.