Family Medical Clinic PLLC
NPI 1477019909ActiveOrganization· Internal Medicine· O Fallon, IL
Internal Medicine in O Fallon, Illinois, registered in NPPES in February 2019. The authorized official on file is Jacqueline Mudd, Authorized Official.
Overview
| NPI | 1477019909 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 20, 2019 |
| Last updated in NPPES | Jul 2, 2020 |
| Certified by provider | Jul 2, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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