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Organization
BLACKHAWK PARK SCHOOL
Active
Organization
BLACKHAWK PARK SCHOOL
Active
Parent organization
WINNEBAGO COUNTY HEALTH DEPARTMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
WINNEBAGO COUNTY HEALTH DEPARTMENT
Authorized official
MR. J MAICHLE BACON (ADMINISTRATOR)
(815) 720-4011
Entity
Organization
Contact information
Practice address
330 15TH AVE, ROCKFORD, IL 61104-5155
(815) 972-7200
(815) 720-4001
Mailing address
401 DIVISION ST, ROCKFORD, IL 61104-2014
(815) 720-4011
(815) 720-4001
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
771115034
IL
Other
Enumeration date
07/08/2009
Last updated
12/12/2012
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