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Logan Primary Care Service Corporation

Family Medicine Physician in Herrin, IL · enumerated 2006 · authorized official Tara Deaton, Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1821105974

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Registry record

Entity type Organization (Type 2)
Legal business name Logan Primary Care Service Corporation
Practice address 405 Rushing Drive, Herrin, IL, 62948
Phone (618) 993-3300
Fax (618) 997-6626
Enumeration date Aug 24, 2006
Last updated in NPPES Nov 29, 2007

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 036099669 (IL) Primary

Authorized official

Name Tara Deaton
Title Administrator
Phone (618) 993-3300

Other identifiers

Identifier Type State Issuer
14D0666068 Other - CLIA
143870 Medicaid IL -
14D0436594 Other - CLIA
14D0963522 Other - CLIA
10019630 Other IL BLUE CROSS BLUE SHIELD
14D1041426 Other - CLIA

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where is Logan Primary Care Service Corporation located?
The practice location on file with NPPES is in Herrin, IL.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2007-11-29. Verify at npiregistry.cms.hhs.gov.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-11-29.