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Organization

COUNTY OF LOGAN

Active
Parent organization
LOGAN COUNTY DEPARTMENT OF PUBLIC HEALTH
Other names
Home Care of Central Illinois
Organization subpart
Yes

Provider details

NPI number
Legal business name
LOGAN COUNTY DEPARTMENT OF PUBLIC HEALTH
Authorized official
MR. MARK HILLIARD (ADMINISTRATOR)
(217) 735-2317
Entity
Organization

Contact information

Practice address
109 3RD ST, LINCOLN, IL 62656-0508
(217) 735-2317
(217) 732-6943
Mailing address
109 3RD ST, P.O. BOX 508, LINCOLN, IL 62656-0508
(217) 735-2317
(217) 732-6943

Taxonomy

Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
IL1001866
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
382030
MEDICARE PART B PROVIDER
IL
01
600002138
RAILROAD MEDICARE PROVIDE
IL
Enumeration date
07/28/2005
Last updated
03/25/2010
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