Active NPI
County of Richland
- State or Local Public Health Clinic/Center
- Olney, IL
National Provider Identifier
1104909407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- State or Local Public Health Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 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
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2341341 | Richland County T B & Public Health Office | Certificate of waiver | Mar 31, 2028 |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Nurse Practitioner
- Olney, IL
- NPI 1336682665
-
- Family Medicine Physician
- West Salem, IL
- NPI 1871589515
-
- Nurse Practitioner
- Olney, IL
- NPI 1982428769
-
- Registered Nurse
- Olney, IL
- NPI 1871059477
-
- Community Health Registered Nurse
- Olney, IL
- NPI 1366785883
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.