County of McDonough McDonough County Clerk
Organization Active NPI Public Health or Welfare Agency · Macomb, IL
NPI 1124155841 · NPPES record last updated May 6, 2013
Key facts
- NPI
- 1124155841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- COUNTY OF MCDONOUGH MCDONOUGH COUNTY CLERK
- Practice address
- 505 E Jackson St
Macomb, IL 61455-2310 - Phone
- (309) 837-9951
- Fax
- (309) 837-1100
- NPI assigned
- Feb 28, 2007
- Organization subpart
- No
Authorized official
- Name
- Ms. Katherine Sue Cleer
- Title
- Business Office Manager
- Phone
- (309) 837-9951
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 1
Corporate family (same tax ID) 2
Practitioners 1
-
Richard Earl Minter, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| The Elms |
Skilled nursing facility | 5% Or Greater Direct Ownership Interest | Dec 17, 2010 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130510000302 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 8820279219 | Practice locations: Macomb, IL |
National Provider Directory
- Tax ID family
- The Elms
Locations
505 E Jackson St
Macomb, IL 61455
Phone (309) 837-9951
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | 336062856 | IL | |
| Public Health or Welfare Agency | 251K00000X | Yes |
Addresses
Primary practice location
505 E Jackson St
Macomb, IL 61455-2310
Mailing address
505 E Jackson St
Macomb, IL 61455-2310
Phone (309) 837-9951
Other names
- McDonough County Health Dept.
Other providers in Macomb, IL
- Deborah Shaw Conner
- Caleb Ray Corrigan
- Counseling Cares P.C.
- Counseling Perspectives, LLC
- Countryside Care Center LLC
- County of McDonough McDonough County Clerk
- Valerie Crabtree
- Brittany Ann Cromer
- Gary R Crosby
- Crossett Pharmacy, Inc
All providers in Macomb, IL · Public Health or Welfare Agency in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.