Organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Active
Parent organization
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Other names
Shawnee Health Care, Same Day
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
404 S. LEWIS LANE, CARBONDALE, IL 62901
(618) 519-9200
(618) 549-1288
Mailing address
PO BOX 577, 109 CALIFORNIA ST., CARTERVILLE, IL 62918-0577
(618) 985-8221
(618) 985-6860
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
H80CS00667
IL
2084P0800X
Psychiatry Physician
H80CS00667
IL
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/17/2016
Last updated
08/05/2024
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