NPIMap

Organization Active NPI

Chaddock

  • Foster Care Agency
  • Quincy, IL
National Provider Identifier
1093063208
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
004048-12 Issued in IL
Legal business name
CHADDOCK
Practice address
921 N 24TH St
Quincy, IL 62301-2267
Phone
(217) 222-0034
Fax
(217) 222-0253
NPI assigned
Aug 17, 2012
Last updated
Sep 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristen Patton
Title
Director of Finance
Phone
(217) 592-0317

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Foster Care Agency 253J00000X 004048-12 IL Primary

Addresses

Primary practice location

921 N 24TH St
Quincy, IL 62301-2267

Mailing address

205 S 24TH St
Quincy, IL 62301-4446
Phone (217) 222-0034

Other identifiers 1

IdentifierTypeStateIssuer
#3A00-IPI-019MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Chaddock7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

921 N 24th St
Quincy, IL 62301
Phone (217) 222-0034

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1345161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1093063208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 S 24TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014446",
            "telephone_number": "217-222-0034",
            "fax_number": "217-222-3865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 N 24TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623012267",
            "telephone_number": "217-222-0034",
            "fax_number": "217-222-0253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHADDOCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-17",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "PATTON",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "217-592-0317"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "IL",
            "license": "004048-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "#3A00-IPI-019",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.