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Organization

LIVINGSTON CO PUBLIC HLTH DEPT

Active
Other names
Pontiac Township High School SCHOOL BASE HEALTH CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MALINDA HILLMAN (ADMINISTRATOR)
(815) 844-7174
Entity
Organization

Contact information

Practice address
1100 E INDIANA AVE, PONTIAC, IL 61764-1204
(815) 844-6113
(815) 842-6517
Mailing address
310 E TORRANCE AVE, PONTIAC, IL 61764-2748
(815) 844-7174
(815) 842-4104

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6176414
IL
Enumeration date
04/09/2008
Last updated
12/28/2011
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