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LOGAN PRIMARY CARE
NPI 1902094352
Nurse Practitioner - Primary Care in Herrin, IL

Active since October 11, 2007
405 RUSHING DR, HERRIN, IL 62948(618) 993-3300(618) 932-3797 Get Directions Write a Review

NPPES record last updated: October 11, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Logan Primary Care NPPES

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

LOGAN PRIMARY CARE (NPI 1902094352) is a healthcare organization registered as a primary care in Herrin, Illinois and active in the NPI registry since October 2007. The organization lists Tara G Deaton, Administrator, as its authorized official.

NPPES Registry Identity

NPI1902094352
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameLOGAN PRIMARY CARE
Location Address405 RUSHING DRHerrin, IL 62948-3730
Mailing Address502 E Saint Louis StWest Frankfort, IL 62896-1346 · (618) 993-3300 · Fax (618) 932-3797
Phone(618) 993-3300
Fax(618) 932-3797
Organization SubpartNo
Authorized OfficialTara G DeatonAdministrator · (618) 997-3400
Enumeration DateOctober 11, 2007
✔ NPI 1902094352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
405 RUSHING DR, Herrin, IL 62948
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Other Identifiers 1

Medicare UPIN509101IL

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

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's NPI number?

The NPI number for Logan Primary Care is 1902094352. It was assigned to this organization in the NPPES registry on October 11, 2007.

Where is Logan Primary Care located?

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

What is Logan Primary Care's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Logan Primary Care was last updated on October 11, 2007. 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.