NPIMap

Organization Active NPI

Christian Social Services of Illinois

  • Foster Care Agency
  • Carbondale, IL
National Provider Identifier
1598031700
Registry record updated May 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foster Care AgencyTaxonomy code 253J00000X
License
003976-12 Issued in IL
Legal business name
CHRISTIAN SOCIAL SERVICES OF ILLINOIS
Practice address
214 S University Ave
Carbondale, IL 62901-2925
Phone
(618) 351-0743
Fax
(618) 351-0945
NPI assigned
Apr 2, 2012
Last updated
May 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2012

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

Authorized official

Name
Mr. Gary R Huelsmann, MSW
Title
Executive Director
Phone
(618) 394-5900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foster Care Agency 253J00000X 003976-12 IL Primary

Addresses

Primary practice location

214 S University Ave
Carbondale, IL 62901-2925

Mailing address

8601 W Main St
Suite 201
Belleville, IL 62223-1719
Phone (618) 394-5900

Other identifiers 4

IdentifierTypeStateIssuer
1275862120MedicaidIL
1902973910MedicaidIL
1104156439MedicaidIL
1942527536OtherILTYPE 2-ORGANIZATION

Other names 1

  • Catholic Social Services of Southern Illinois, Diocese of Belleville Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Margaret M Mensen LCSW24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

214 S University Ave
Carbondale, IL 62901
Phone (618) 351-0743

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337212800000",
    "number": "1598031700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 W MAIN ST",
            "address_2": "SUITE 201",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622231719",
            "telephone_number": "618-394-5900",
            "fax_number": "618-394-5909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 S UNIVERSITY AVE",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629012925",
            "telephone_number": "618-351-0743",
            "fax_number": "618-351-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN SOCIAL SERVICES OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-05-17",
        "status": "A",
        "authorized_official_last_name": "HUELSMANN",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "618-394-5900",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "253J00000X",
            "taxonomy_group": "",
            "desc": "Foster Care Agency",
            "state": "IL",
            "license": "003976-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1275862120",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1902973910",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104156439",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 2-ORGANIZATION",
            "identifier": "1942527536",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Catholic Social Services of Southern Illinois, Diocese of Belleville",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2012; 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.