NPIMap

Organization Active NPI

Egyptian Health Department

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fairfield, IL
National Provider Identifier
1699242131
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
EGYPTIAN HEALTH DEPARTMENT
Practice address
407 N Basin Rd
Fairfield, IL 62837-9639
Phone
(618) 273-3326
Fax
(618) 273-2808
NPI assigned
Nov 1, 2018
Last updated
May 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Authorized official

Name
Angie Hampton
Title
Ceo
Phone
(618) 273-3326

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

407 N Basin Rd
Fairfield, IL 62837-9639

Mailing address

1412 US Highway 45 N
Eldorado, IL 62930-3766
Phone (618) 273-3326

Other identifiers 1

IdentifierTypeStateIssuer
04051MedicaidIL

Other names 1

  • Egyptian Behavioral Health Other name

National Provider Directory

National Provider Directory
Tax ID family
Egyptian Health Department20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

Locations

1412 US Highway 45 N
Eldorado, IL 62930
Phone (618) 273-3326

NPI Registry JSON

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590624000000",
    "number": "1699242131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1412 US HIGHWAY 45 N",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303766",
            "telephone_number": "618-273-3326",
            "fax_number": "618-273-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N BASIN RD",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628379639",
            "telephone_number": "618-273-3326",
            "fax_number": "618-273-2808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EGYPTIAN HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A",
        "authorized_official_last_name": "HAMPTON",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "618-273-3326"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04051",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Egyptian Behavioral Health",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Egyptian Behavioral Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.