Organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Active
Organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Active
Parent organization
CRUSADERS CENTRAL CLINIC ASSOCIATION
Other names
Crusader Clinic Belvidere
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRUSADERS CENTRAL CLINIC ASSOCIATION
Authorized official
SAMUEL MILLER (PRESIDENT & CEO)
(815) 490-1737
Entity
Organization
Contact information
Practice address
1050 LOGAN AVE, BELVIDERE, IL 61008-3966
(815) 547-0282
(815) 490-1625
Mailing address
1050 LOGAN AVE, BELVIDERE, IL 61008-3966
(815) 490-1600
(815) 490-1845
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027548
CHAMPUS
—
01
—
1011514778
BLUE CROSS BLUE SHIELD
—
01
—
106483
DORAL
IL
Enumeration date
02/18/2008
Last updated
08/24/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up