Organization
CENTRAL COUNTIES HEALTH CENTERS, INC.
Active
Organization
CENTRAL COUNTIES HEALTH CENTERS, INC.
Active
Other names
Capitol Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
CINDY KAVANAGH (ACCOUNTANT)
(217) 788-2300
Entity
Organization
Contact information
Practice address
2239 E COOK ST, SPRINGFIELD, IL 62703-1944
(217) 788-2300
(217) 788-2343
Mailing address
2239 E COOK ST, SPRINGFIELD, IL 62703-1944
(217) 788-2300
(217) 788-2343
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
122300000X
Dentist
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IL
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/13/2005
Last updated
09/02/2016
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