Organization
CENTRAL COUNTIES HEALTH CENTERS, INC.
Active
Other names
Capitol Community Health Center - St John's Breadline
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY KAVANAGH (ACCOUNTANT)
(217) 788-2300
Entity
Organization
Contact information
Practice address
430 N 5TH ST, ST JOHN'S BREADLINE, SPRINGFIELD, IL 62702-5202
(217) 788-2300
(217) 788-2343
Mailing address
2239 E COOK ST, HCH - ST JOHN'S BREADLINE, SPRINGFIELD, IL 62703-1944
(217) 788-2300
(217) 788-2343
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
Other
Enumeration date
01/08/2007
Last updated
09/21/2010
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