County of Carroll
Organization Active NPI Health Service Clinic/Center · Mount Carroll, IL
NPI 1952463705 · NPPES record last updated Feb 14, 2014
Key facts
- NPI
- 1952463705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Health Service Clinic/Center 261QH0100X
- Legal business name
- COUNTY OF CARROLL
- Practice address
- 822 S Mill St
Mount Carroll, IL 61053-1243 - Phone
- (815) 244-8855
- Fax
- (815) 244-5010
- NPI assigned
- Dec 15, 2006
- Organization subpart
- No
Authorized official
- Name
- Mrs. Dawn Holland
- Title
- Office Manager
- Phone
- (815) 244-8855
Corporate family (same tax ID) 1
Practitioners 4
-
Kathleen Allen, RN
-
Dolores Downs, RN, BSN
-
Jennifer Miller, RN
-
Kristen R Simpson, R.N.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20051202000359 | IL | Part B Supplier - Mass Immunization (Roster Biller Only) | 2668492869 | Practice locations: Mount Carroll, IL |
National Provider Directory
- Tax ID family
- County of Carroll
Locations
822 S Mill St
Mount Carroll, IL 61053
Phone (815) 244-8855
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Service Clinic/Center | 261QH0100X | Yes |
Addresses
Primary practice location
822 S Mill St
Mount Carroll, IL 61053-1243
Mailing address
822 S Mill St
Mount Carroll, IL 61053-1243
Phone (815) 244-8855
Other names
- Carroll County Health Department
Other providers in Mount Carroll, IL
- Katelin Marie Breuning
- Carroll County Health Department
- Sharon Kay Chadwick
- Complete Compassionate Care Inc.
- Angela K Conklin
- Tymi Lynn Currens
- Deyo Chiropractic Center LTD
- Ronald Adrian Deyo
- Christopher Gene Dinning
- Brenda Dorsey
All providers in Mount Carroll, IL · Health Service Clinic/Center in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 14, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.