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Contact Information

FORT HEALTH MEDICAL GROUP PA
600 S 2ND ST STE 404
SPRINGFIELD, IL62704-2542
 Phone: 201-208-2616
 Fax: 973-381-5773
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Clinical Child & Adolescent

103TC2200X 62 Psychologist, Clinical
 

Professional

101YP2500X
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for FORT HEALTH MEDICAL GROUP PA

NPI # 1972342046
LBN Legal business name FORT HEALTH MEDICAL GROUP PA
Authorized official TRACI CROSBY - (CREDENTIALING MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/20/2024
Last updated 03/26/2025 - More than a year ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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