NPIMap

Organization Active NPI

Champaign Urbana Public Health Department

  • Public Health or Welfare Agency
  • Champaign, IL
National Provider Identifier
1366693632
Registry record updated Oct 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
251K00000X Issued in IL
Legal business name
CHAMPAIGN URBANA PUBLIC HEALTH DEPARTMENT
Practice address
201 W Kenyon Rd
Champaign, IL 61820-7807
Phone
(217) 531-4279
Fax
(217) 531-4333
NPI assigned
Oct 6, 2008
Organization subpart
Yes
Parent organization
SEALANT PROGRAMAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2008

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

Authorized official

Name
Ms. Julie Pryde
Title
Interim Adminitrator
Phone
(217) 531-5369

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 251K00000X IL Primary

Addresses

Primary practice location

201 W Kenyon Rd
Champaign, IL 61820-7807

Mailing address

201 W Kenyon Rd
Champaign, IL 61820-7807
Phone (217) 531-4279

Other identifiers 1

IdentifierTypeStateIssuer
1285832006MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Champaign Urbana Public Health5 organizations share this tax ID, including this one
Part of
Champaign Urbana Public Health

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1366693632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 W KENYON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207807",
            "telephone_number": "217-531-4279",
            "fax_number": "217-531-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 W KENYON RD",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618207807",
            "telephone_number": "217-531-4279",
            "fax_number": "217-531-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPAIGN URBANA PUBLIC HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SEALANT PROGRAM",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "PRYDE",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "INTERIM ADMINITRATOR",
        "authorized_official_telephone_number": "217-531-5369",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "IL",
            "license": "251K00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1285832006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; 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.