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Organization

ILLINOIS DEPARTMENT OF PUBLIC HEALTH

Active
Other names
HIV/AIDS Section
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MATT CHARLES (HIV/AIDS ASSISTANT SECTION CHIEF)
(217) 782-1207
Entity
Organization

Contact information

Practice address
525 WEST JEFFERSON, 1ST FLOOR, SPRINGFIELD, IL 62761
(217) 524-5983
(217) 524-6090
Mailing address
525 WEST JEFFERSON, 1ST FLOOR, SPRINGFIELD, IL 62761
(217) 524-5983
(217) 524-6090

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
IL

Other

Enumeration date
11/25/2009
Last updated
11/25/2009
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