Illinois Department of Public Health

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ILLINOIS DEPARTMENT OF PUBLIC HEALTH

Doing business as

HIV/AIDS Section

Practice address

525 West Jefferson
1St Floor
Springfield, IL 62761

Phone

(217) 524-5983

Fax

(217) 524-6090

NPI assigned

Nov 25, 2009

Last updated

Nov 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Matt Charles

Title

HIV/AIDS Assistant Section Chief

Phone

(217) 782-1207

Specialties & licenses 1

Addresses

Other names 1

• HIV/AIDS Section Doing business as

Tax ID family

Hivaids Section2 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.

• Illinois Department of Public Health

  • Clinical Medical Laboratory
  • Springfield, IL
  • NPI 1992925580
  NPD tax ID

Locations

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

{
    "created_epoch": "1259107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1891023164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 WEST JEFFERSON",
            "address_2": "1ST FLOOR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62761",
            "telephone_number": "217-524-5983",
            "fax_number": "217-524-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 WEST JEFFERSON",
            "address_2": "1ST FLOOR",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "62761",
            "telephone_number": "217-524-5983",
            "fax_number": "217-524-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLINOIS DEPARTMENT OF PUBLIC HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-25",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "HIV/AIDS ASSISTANT SECTION CHIEF",
        "authorized_official_telephone_number": "217-782-1207",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HIV/AIDS Section",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Carlos Ignacio Illingworth Garcia, M.D.
• Illini Cares
• Illinois Department of Human (DHS Central Outpatient Pharmacy)
• Illinois Department of Human Services (Andrew McFarland Mental Health Center)
• Illinois Department of Human Services
• Illinois Department of Public Health
• Illinois Diagnostic Imaging, Inc (Springfield MRI & Imaging Center)
• Illinois Pharmacists Management Enterprises, LLC (Illinois Community Pharmacy Enhanced Network and Clinic Services)
• Illinois Spine Center SC (Clem Chiropractic Center)
• Morayo Ilubanwo

• Clinical Medical Laboratory in Springfield, IL
• Providers in Springfield, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.