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FAMILY MEDICAL CLINIC PLLC
NPI 1477019909
Internal Medicine in O Fallon, IL

Active since February 20, 2019
1480 N GREEN MOUNT RD SUITE 200, O FALLON, IL 62269(618) 622-3450(618) 622-3468 Get Directions Write a Review

NPPES record last updated: July 2, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 2, 2020, May 7, 2020, May 10, 2019 and 1 more (4 updates tracked since 2019).

About Family Medical Clinic Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY MEDICAL CLINIC PLLC (NPI 1477019909) is a healthcare organization registered as an internal medicine in O Fallon, Illinois and active in the NPI registry since February 2019. The organization lists Jacqueline Mudd, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1477019909
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameFAMILY MEDICAL CLINIC PLLC
Location Address1480 N GREEN MOUNT RD SUITE 200O Fallon, IL 62269-3466
Mailing AddressPo Box 483Litchfield, IL 62056-0483 · (217) 324-1100 · Fax (217) 324-1103
Phone(618) 622-3450
Fax(618) 622-3468
Organization SubpartNo
Authorized OfficialJacqueline MuddAuthorized Official · (217) 324-1100
Enumeration DateFebruary 20, 2019
Last NPPES UpdateJuly 2, 20204 updates tracked since enumeration
NPPES CertifiedJuly 2, 2020
✔ NPI 1477019909 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedFamily MedicineTaxonomy 207Q00000X
1480 N GREEN MOUNT RD SUITE 200, O Fallon, IL 62269
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Other Identifiers 1

OtherDZ1647IL · Railroad Medicare Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Family Medical Clinic PLLC's NPI number?

The NPI number for Family Medical Clinic PLLC is 1477019909. It was assigned to this organization in the NPPES registry on February 20, 2019.

Where is Family Medical Clinic PLLC located?

Family Medical Clinic PLLC is located at 1480 N Green Mount Rd Suite 200, O Fallon, IL 62269. The listed phone number is (618) 622-3450.

What is Family Medical Clinic PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Family Medical Clinic PLLC was last updated on July 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.