Organization
SHAWNEE HEALTH SERVICE & DEVELOPMENT CORP
Active
Parent organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Other names
Shawnee Health Care, Carbondale Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Authorized official
CHRISTINA CARNEY (CEO)
(618) 956-9521
Entity
Organization
Contact information
Practice address
402 S. LEWIS LANE, CARBONDALE, IL 62901
(618) 519-9901
Mailing address
109 CALIFORNIA ST, PO BOX 577, CARTERVILLE, IL 62918-1923
(618) 985-8221
(618) 985-6860
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
IL
1223P0221X
Pediatric Dentistry
—
IL
124Q00000X
Dental Hygienist
—
IL
126800000X
Dental Assistant
—
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019027984
—
IL
05
—
019028085
—
IL
05
—
019028089
—
IL
05
—
019028144
—
IL
05
—
019028149
—
IL
05
—
019028752
—
IL
Enumeration date
10/30/2009
Last updated
04/04/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us