Organization
PROMISE HEALTHCARE NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HENRY (CEO)
(217) 403-5401
Entity
Organization
Contact information
Practice address
424 E WABASH AVE, RANTOUL, IL 61866-3013
(217) 356-1558
Mailing address
819 BLOOMINGTON RD, CHAMPAIGN, IL 61820-2101
(217) 356-1558
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
Other
Enumeration date
12/15/2023
Last updated
06/03/2024
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