NPIMap

Organization Active NPI

Livingston County

  • Community Health Clinic/Center
  • Pontiac, IL
National Provider Identifier
1255398517
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
LIVINGSTON COUNTY
Practice address
310 E Torrance Ave
Pontiac, IL 61764-2748
Phone
(815) 844-7174
Fax
(815) 842-1063
NPI assigned
Apr 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Mrs. Erin Fogarty, PHD, MPH, MCHES
Title
Administrator
Phone
(815) 842-5908

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

310 E Torrance Ave
Pontiac, IL 61764-2748

Mailing address

310 E Torrance Ave
Pontiac, IL 61764-2748
Phone (815) 844-7174

Other names 1

  • Livingston County Public Health Department Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111021000561 IL Part B Supplier - Clinic/Group Practice 5496796005 Receives reassigned benefits from 1 practitioner
Practice locations: Pontiac, 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
14D0646839Livingston County Health Department310 E Torrance Avenue, Pontiac, IL 61764Provider-performed microscopyOct 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
Livingston Co Public HLTH Dept10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

310 E Torrance Ave
#100
Pontiac, IL 61764

Practitioners & affiliated clinicians

Practitioners 1

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": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1255398517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E TORRANCE AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617642748",
            "telephone_number": "815-844-7174",
            "fax_number": "815-842-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E TORRANCE AVE",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617642748",
            "telephone_number": "815-844-7174",
            "fax_number": "815-842-1063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVINGSTON COUNTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "FOGARTY",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "815-842-5908",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PHD, MPH, MCHES"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Livingston County Public Health Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pontiac, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.