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LOGAN PRIMARY CARE SERVICE CORPORATION
NPI 1730296880
Clinic/Center - Rural Health in Herrin, IL

Active since August 24, 2006
405 RUSHING DR, HERRIN, IL 62948(618) 993-3300(618) 997-6626 Get Directions Write a Review

NPPES record last updated: April 15, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Logan Primary Care Service Corporation NPPES

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

LOGAN PRIMARY CARE SERVICE CORPORATION (NPI 1730296880) is a healthcare organization registered as a rural health in Herrin, Illinois and active in the NPI registry since August 2006. The organization lists Tara Gayel Deaton, Administrator, as its authorized official.

NPPES Registry Identity

NPI1730296880
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameLOGAN PRIMARY CARE SERVICE CORPORATION
Location Address405 RUSHING DRHerrin, IL 62948
Mailing Address405 Rushing DrHerrin, IL 62948 · (618) 993-3300 · Fax (618) 997-6626
Phone(618) 993-3300
Fax(618) 997-6626
Organization SubpartNo
Authorized OfficialTara Gayel DeatonAdministrator · (618) 993-3300
Enumeration DateAugust 24, 2006
Last NPPES UpdateApril 15, 2008
✔ NPI 1730296880 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
405 RUSHING DR, Herrin, IL 62948
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Other Identifiers 3

Medicaid143870IL
Medicare UPINE26544
Medicare ID-Type Unspecified336570

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIN FRANCIS LCSW
Social Worker (Clinical)
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
DR. GOWDA SHARATH MD
Internal Medicine
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LENORA ANN LEVIN
Social Worker (Clinical)
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LESLIE ANN HICKMAN NP
Nurse Practitioner
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LOGAN PRIMARY CARE
Physician Assistant
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
KALLIE M FRENCH PAC
Physician Assistant
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
LAURA UTLEY APN
Nurse Practitioner
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300
VICTORIA DARE NP
Nurse Practitioner
405 RUSHING DR
HERRIN, IL 62948
Williamson County (618) 993-3300

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 Logan Primary Care Service Corporation's NPI number?

The NPI number for Logan Primary Care Service Corporation is 1730296880. It was assigned to this organization in the NPPES registry on August 24, 2006.

Where is Logan Primary Care Service Corporation located?

Logan Primary Care Service Corporation is located at 405 Rushing Dr, Herrin, IL 62948. The listed phone number is (618) 993-3300.

What is Logan Primary Care Service Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Logan Primary Care Service Corporation was last updated on April 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.