Mason County
Organization Active NPI Public Health or Welfare Agency · Havana, IL
NPI 1235340951 · NPPES record last updated May 11, 2026
Key facts
- NPI
- 1235340951
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health or Welfare Agency 251K00000X
- Legal business name
- MASON COUNTY
- Practice address
- 1002 E Laurel Ave
Havana, IL 62644-6973 - Phone
- (309) 210-0110
- Fax
- (309) 543-2063
- NPI assigned
- May 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Jessica Towery
- Title
- Administrator
- Phone
- (309) 210-0110
Corporate family (same tax ID) 1
Practitioners 3
-
Jessica Poling, IBCLC
-
Aaron Costerisan, M.D.
-
Michael Scott Markley, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D0663303 | Mason County Health Dept | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040922000101 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 9830167451 | Practice locations: Havana, IL |
National Provider Directory
- Tax ID family
- Mason County
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health or Welfare Agency | 251K00000X | Yes | ||
| In Home Supportive Care Agency | 253Z00000X | |||
| State or Local Public Health Clinic/Center | 261QP0905X |
Addresses
Primary practice location
1002 E Laurel Ave
Havana, IL 62644-6973
Mailing address
1002 E Laurel Ave
Havana, IL 62644-6973
Phone (309) 210-0110
Other names
- Mason County Health Department
Other providers in Havana, IL
- Kelsey Elizabeth Knake
- Sarah Knake
- Kelley D Lawless
- Liberty Dental, Inc
- Ashley Marmon
- Mason County Health Department
- Mason District Hospital
- Mason District Hospital
- Mason District Hospital
- Mason District Hospital
All providers in Havana, 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 11, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.