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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