Organization · Type 2 NPI

Crusaders Central Clinic Association

Federally Qualified Health Center (FQHC) · Rockford, IL

NPI number 1265601488 Active

Practice location

1100 Broadway
Rockford, IL 61104-1429

Fax (815) 490-1625

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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

7 other providers at this address

Crusaders Central Clinic AssociationHealth Educator Rockford, IL NPI 1841970068
Laboratory Corporation of AmericaClinical Medical Laboratory Rockford, IL NPI 1427601855
Amanda Catherine Fraser, PA-CPhysician Assistant Rockford, IL NPI 1609619691
Anastasia Peer-DrakePediatric Nurse Practitioner Rockford, IL NPI 1417879727
Catherine Louise Pieper, PHARMACISTPharmacist Rockford, IL NPI 1952474256
Heather Moon Piper, R.N., M.S., C.N.M.Advanced Practice Midwife Rockford, IL NPI 1336455773
Theresa Marie Sheahan, NPFamily Nurse Practitioner Rockford, IL NPI 1871023341

Other federally qualified health center (fqhc) providers in Rockford

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NPI record

NPI: 1265601488
Entity type: Organization (Type 2)
Issued: Feb 21, 2008
Last updated: Aug 24, 2022
Status: Active
Subpart: Yes of Crusaders Central Clinic Association

Other names

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Crusader Clinic Broadway · doing business as

Authorized official

Samuel Miller
President & CEO
(815) 490-1737

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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 1265601488

Crusaders Central Clinic Association's National Provider Identifier is 1265601488, issued on Feb 21, 2008. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Rockford, IL. The record was last updated on Aug 24, 2022.