MAIN STREET MEDICAL CLINIC LLC
NPI 1649345125
Nurse Practitioner - Family in Benton, IL

Q: What is Main Street Medical Clinic LLC's NPI number?

The NPI number for Main Street Medical Clinic LLC is 1649345125. It was assigned to this organization in the NPPES registry on November 21, 2006.

Q: What is Main Street Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since November 21, 2006

505 N MAIN ST, BENTON, IL 62812(618) 435-4310(618) 435-4384 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Main Street Medical Clinic Llc NPPES

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

MAIN STREET MEDICAL CLINIC LLC (NPI 1649345125) is a healthcare organization registered as a family in Benton, Illinois and active in the NPI registry since November 2006. The organization lists Debbie Lynn Holman, Np, as its authorized official.

NPPES Registry Identity

NPI1649345125

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameMAIN STREET MEDICAL CLINIC LLC

Location Address505 N MAIN STBenton, IL 62812-1102

Mailing Address505 N Main StBenton, IL 62812-1102 · (618) 435-4310 · Fax (618) 435-4384

Phone(618) 435-4310

Fax(618) 435-4384

Organization SubpartNo

Authorized OfficialDebbie Lynn HolmanNp · (618) 435-4310

Enumeration DateNovember 21, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1649345125 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

505 N MAIN ST, Benton, IL 62812

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 Main Street Medical Clinic LLC's NPI number?

The NPI number for Main Street Medical Clinic LLC is 1649345125. It was assigned to this organization in the NPPES registry on November 21, 2006.

Where is Main Street Medical Clinic LLC located?

Main Street Medical Clinic LLC is located at 505 N Main St, Benton, IL 62812. The listed phone number is (618) 435-4310.

What is Main Street Medical Clinic LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Main Street Medical Clinic LLC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.