Organization · Type 2 NPI

Crusaders Central Clinic Association

Federally Qualified Health Center (FQHC) · Belvidere, IL

NPI number 1780852244 Active

Practice location

1050 Logan Ave
Belvidere, IL 61008-3966

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...

Another provider at this address

Laboratory Corporation of AmericaClinical Medical Laboratory Belvidere, IL NPI 1578116901

NPI record

NPI: 1780852244
Entity type: Organization (Type 2)
Issued: Feb 18, 2008
Last updated: Aug 24, 2022
Status: Active
Subpart: Yes of Crusaders Central Clinic Association

Other names

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Crusader Clinic Belvidere · 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 1780852244

Crusaders Central Clinic Association's National Provider Identifier is 1780852244, issued on Feb 18, 2008. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Belvidere, IL. The record was last updated on Aug 24, 2022.