Duquoin Comm Unit Dist 300

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

DUQUOIN COMM UNIT DIST 300

Practice address

845 East Jackson Street
Duquoin, IL 62832

Phone

(618) 542-3856

Fax

(618) 542-6614

NPI assigned

Apr 24, 2007

Organization subpart

No

Tax ID family

Du Quoin Community Unit School2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Du Quoin Community Unit School

  • Student Health Clinic/Center
  • Du Quoin, IL
  • NPI 1154592780
  NPD tax ID

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

Authorized official

Name

Dr. Gary Kelly, PHD

Title

District Superintendent

Phone

(618) 542-3856

Specialties & licenses 1

Addresses

Other names 1

• Du Quoin Community Unit School Other name

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295954600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 EAST JACKSON STREET",
            "city": "DUQUOIN",
            "state": "IL",
            "postal_code": "62832",
            "telephone_number": "618-542-3856",
            "fax_number": "618-542-6614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 EAST JACKSON STREET",
            "city": "DUQUOIN",
            "state": "IL",
            "postal_code": "62832",
            "telephone_number": "618-542-3856",
            "fax_number": "618-542-6614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUQUOIN COMM UNIT DIST 300",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DISTRICT SUPERINTENDENT",
        "authorized_official_telephone_number": "618-542-3856",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Du Quoin Community Unit School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ashley Lorraine Delaney, LPN
• Ariele N. Loiacono, FNP
• John Wesley Melvin, DC
• Michael H Poiter, PA-C
• Heather Richelman, PT
• Patrick L Riley, MD

• All providers in Duquoin, IL
• Student Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.