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Organization

ILLINI CHRISTIAN MINISTRIES INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TONY Y KIRKMAN LCPC (EXEC DIR)
(217) 469-7566
Entity
Organization

Contact information

Practice address
204 N MAIN ST, SUITE 203, SAINT JOSEPH, IL 61873
(217) 469-7566
(217) 469-2568
Mailing address
PO BOX 200, 204 N. MAIN SUITE 203, SAINT JOSEPH, IL 61873-0200
(217) 469-7566
(217) 469-2568

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
178003791
IL
103T00000X
Psychologist
180000680
IL

Other

Enumeration date
09/29/2006
Last updated
12/30/2010
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