Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Passavant Physician Association

Multi-Specialty Clinic/Center in Jacksonville, IL · enumerated 2008 · authorized official Wendi Graham, Practice Plan Administrator.

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

National Provider Identifier

1962689307

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Registry record

Entity type Organization (Type 2)

Legal business name Passavant Physician Association

Practice address 1600 W Walnut St, Jacksonville, IL, 62650

Phone (217) 479-5890

Fax (217) 243-2206

Enumeration date Jan 29, 2008

Last updated in NPPES Mar 21, 2018

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary

207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary

207VX0000X Obstetrics Physician Allopathic & Osteopathic Physicians · License 036048526 (IL) Secondary

207Y00000X Otolaryngology Physician Allopathic & Osteopathic Physicians · License 036057937 (IL) Secondary

2083P0011X Undersea and Hyperbaric Medicine (Preventive Medicine) Physician Allopathic & Osteopathic Physicians Secondary

208600000X Surgery Physician Allopathic & Osteopathic Physicians Secondary

231H00000X Audiologist Speech, Language and Hearing Service Providers Secondary

261QM1300X Multi-Specialty Clinic/Center Ambulatory Health Care Facilities Primary

363LA2200X Adult Health Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Wendi Graham

Title Practice Plan Administrator

Phone (217) 479-5663

Other identifiers

Identifier	Type	State	Issuer
6932023	Other	IL	BCBS
DH1383	Other	IL	RAILROAD PTAN
IL2621	Other	IL	2ND LOCATION MEDICARE PIN #

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.

Read the full guide → Validate an NPI →

Frequently asked questions

What type of organization is Passavant Physician Association?

Passavant Physician Association is registered in NPPES as a Multi-Specialty Clinic/Center (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-03-21.