Organization · Type 2 NPI

Shawnee Health Service and Development Corp

Federally Qualified Health Center (FQHC) · Murphysboro, IL

NPI number 1245260645 Active

Practice location

7 South Hospital Drive
Murphysboro, IL 62966-3333

Call (618) 687-3418 Map

Fax (618) 684-2748

Mailing address

PO Box 577, 109 California Street
Carterville, IL 62918-0577

Specialties and licenses

Taxonomy	Code	License
Mental Health Counselor	101YM0800X	None listed
Clinical Social Worker	1041C0700X	None listed
General Practice Dentistry	1223G0001X	None listed
Dental Hygienist	124Q00000X	None listed
Family Medicine Physician	207Q00000X	None listed
Obstetrics Physician	207VX0000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

3 other providers at this address

NPI record

NPI: 1245260645
Entity type: Organization (Type 2)
Issued: Jul 3, 2006
Last updated: Jul 17, 2024
Status: Active
Subpart: Yes of Shawnee Health Service and Development Corp

Other names

<unavail>
Shawnee Health Care, Murphysboro · doing business as

Authorized official

Christina Carney
CEO
(618) 956-9521

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1245260645

Shawnee Health Service and Development Corp's National Provider Identifier is 1245260645, issued on Jul 3, 2006. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Murphysboro, IL. The record was last updated on Jul 17, 2024.