Organization · Type 2 NPI
Shawnee Health Service and Development Corp
Federally Qualified Health Center (FQHC) · Marion, IL
NPI number
1245944008
Active
Practice location
420 E Main St
Marion, IL 62959-2669
Fax (618) 998-0880
Mailing address
109 California St, PO Box 577
Carterville, IL 62918
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 |
| Federally Qualified Health Center (FQHC) Primary | 261QF0400X | None listed |
Federally Qualified Health Center (FQHC): Definition to come...
Another provider at this address
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About NPI 1245944008
Shawnee Health Service and Development Corp's National Provider Identifier is 1245944008, issued on Jan 6, 2023. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Marion, IL. The record was last updated on Jul 29, 2024.