Organization
CHAMPAIGN URBANA PUBLIC HEALTH DEPARTMENT
Active
Parent organization
SEALANT PROGRAM
Organization subpart
Yes
Provider details
NPI number
Legal business name
SEALANT PROGRAM
Authorized official
MS. JULIE PRYDE (INTERIM ADMINITRATOR)
(217) 531-5369
Entity
Organization
Contact information
Practice address
201 W KENYON RD, CHAMPAIGN, IL 61820-7807
(217) 531-4279
(217) 531-4333
Mailing address
201 W KENYON RD, CHAMPAIGN, IL 61820-7807
(217) 531-4279
(217) 531-4333
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
251K00000X
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285832006
—
IL
Enumeration date
10/06/2008
Last updated
10/06/2008
About Stedi
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