Organization · Type 2 NPI

Shawnee Health Service and Development Corp

Federally Qualified Health Center (FQHC) · Marion, IL

NPI number 1356677058 Active

Practice location

3115 Williamson County Pkwy
Marion, IL 62959-5235

Call (618) 969-8600 Map

Fax (618) 997-1214

Mailing address

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

Specialties and licenses

Taxonomy	Code	License
Dentist	122300000X	None listed
Pediatric Dentistry	1223P0221X	None listed
Dental Hygienist	124Q00000X	None listed
Dental Assistant	126800000X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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

4 other providers at this address

Other federally qualified health center (fqhc) providers in Marion

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NPI record

NPI: 1356677058
Entity type: Organization (Type 2)
Issued: Oct 30, 2009
Last updated: Dec 10, 2025
Status: Active
Subpart: Yes of Shawnee Health Service and Development Corp

Other names

<unavail>
Shawnee Health Care, Marion Dental · doing business as
Shawnee Health, Children's Dental Center - General Care · 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 1356677058

Shawnee Health Service and Development Corp's National Provider Identifier is 1356677058, issued on Oct 30, 2009. 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 Dec 10, 2025.