Organization Active NPI

County of Richland

  • State or Local Public Health Clinic/Center
  • Olney, IL
National Provider Identifier
1104909407
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
State or Local Public Health Clinic/CenterTaxonomy code 261QP0905X
Legal business name
COUNTY OF RICHLAND
Practice address
208 E Main St
Olney, IL 62450-2114
Phone
(618) 392-6241
Fax
(618) 393-4078
NPI assigned
Oct 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Authorized official

Name
Sidney Harrison
Title
Administrative Assistant
Phone
(618) 392-6241

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163W00000X 041-189529 IL
State or Local Public Health Clinic/Center 261QP0905X Primary
Primary Care Clinic/Center 261QP2300X

Addresses

Primary practice location

208 E Main St
Olney, IL 62450-2114

Mailing address

208 E Main St
Olney, IL 62450-2114
Phone (618) 392-6241

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180406002171 IL Part B Supplier - Clinic/Group Practice 5092975466 Receives reassigned benefits from 2 practitioners
Practice locations: Olney, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2341341Richland County T B & Public Health Office208 E Main Street, Olney, IL 62450Certificate of waiverMar 31, 2028

National Provider Directory

National Provider Directory

Locations

208 E Main St
Olney, IL 62450
Phone (618) 392-3090

950 S West St
Olney, IL 62450
Phone (618) 392-6241

501 S Whittle Ave
Olney, IL 62450
Phone (618) 392-6241

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757635200000",
    "number": "1104909407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E MAIN ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502114",
            "telephone_number": "618-392-6241",
            "fax_number": "618-393-4078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 E MAIN ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "624502114",
            "telephone_number": "618-392-6241",
            "fax_number": "618-393-4078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF RICHLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "618-392-6241"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041-189529",
            "primary": false
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.