Organization
CENTRAL COUNTIES HEALTH CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY KAVANAGH (ACCOUNTANT)
(217) 788-2300
Entity
Organization
Contact information
Practice address
1141 N CHENEY ST, TAYLORVILLE, IL 62568-2741
(217) 788-2300
(217) 788-2342
Mailing address
2239 E COOK ST, SPRINGFIELD, IL 62703-1944
(217) 788-2300
(217) 788-2343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
10/06/2016
Last updated
10/06/2016
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