Organization
BLACKHAWK PARK SCHOOL
Active
Parent organization
WINNEBAGO COUNTY HEALTH DEPARTMENT
Organization subpart
Yes
Provider details
NPI number
Legal business name
WINNEBAGO COUNTY HEALTH DEPARTMENT
Authorized official
MR. J MAICHLE BACON (ADMINISTRATOR)
(815) 720-4011
Entity
Organization
Contact information
Practice address
330 15TH AVE, ROCKFORD, IL 61104-5155
(815) 972-7200
(815) 720-4001
Mailing address
401 DIVISION ST, ROCKFORD, IL 61104-2014
(815) 720-4011
(815) 720-4001
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
771115034
IL
Other
Enumeration date
07/08/2009
Last updated
12/12/2012
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