Organization
MACOUPIN COUNTY PUBLIC HEALTH DEPARTMENT
Active
Other names
Columbian Boulevard Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY BLANK (CEO)
(217) 930-2283
Entity
Organization
Contact information
Practice address
125 W COLUMBIAN BLVD S, LITCHFIELD, IL 62056-3021
(217) 854-3223
Mailing address
205 OAKLAND AVE, CARLINVILLE, IL 62626-1921
(217) 839-7820
(217) 839-1538
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/20/2020
Last updated
03/10/2025
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