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Proactive MD Il Sc

Primary Care Clinic/Center in O Fallon, IL · enumerated 2025 · authorized official Mark Kemble, Chief Medical Officer.

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

National Provider Identifier

1881488773

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Registry record

Entity type Organization (Type 2)
Legal business name Proactive MD Il Sc
Practice address 1472 N Green Mount Rd, O Fallon, IL, 62269
Phone (730) 240-8040
Enumeration date Apr 7, 2025
Last updated in NPPES Aug 31, 2026

Taxonomy & classification

261QP2300X Primary Care Clinic/Center Ambulatory Health Care Facilities Primary

Authorized official

Name Mark Kemble
Title Chief Medical Officer
Phone (864) 640-8355

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

How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2026-08-31. Verify at npiregistry.cms.hhs.gov.
Where is Proactive MD Il Sc located?
The practice location on file with NPPES is in O Fallon, IL.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-08-31.