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Contact Information

JESSICA BROUGH
800 N 1ST ST
SPRINGFIELD, IL62702-3778
 Phone: 217-528-7541
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Physician Assistant

363A00000X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for JESSICA BROUGH · (Female)

NPI Number 1356961908
Status Active
Credentials
Entity Individual
Enumeration date 04/23/2020
Last updated 05/01/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 085008034
Hospital affiliation(s)
  • MEMORIAL MEDICAL CENTER - (Acute Care)
    701 N FIRST ST
    SPRINGFIELD, IL 62781
  • PASSAVANT AREA HOSPITAL - (Acute Care)
    1600 W WALNUT ST
    JACKSONVILLE, IL 62650
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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