ST JOSEPH CCSD169 (NPI# 1689899288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689899288 |
| Entity Type | Organization |
| Organization Name | ST JOSEPH CCSD169 |
| Practice Address |
409 S 5th St Saint Joseph IL 61873-9041 |
| Mailing Address |
Po Box 409 Saint Joseph IL 61873-0409 |
| Practice Telephone | 2174692291 |
| Practice Fax Number | 2174698906 |
| Mailing Telephone | 2174692291 |
| Mailing Fax Number | 2174698906 |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TODD PENCE (SUPERINTENDENT) |
| Authorized Official Telephone | 2174692291 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Street Address |
409 S 5TH ST |
| City | SAINT JOSEPH |
| State | IL |
| Zip Code | 61873-9041 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497175442 | Athletico Ltd | Physical Therapist | 109 N. Main Street, Saint Joseph, IL 61873 | 2014-04-17 |
| 1225182702 | Alina Paul | Family Medicine | 226 E Lincoln, St Joseph, IL 61873 | 2007-01-22 |
| 1750484036 | Edmund R. Rudnicke II, Prof Corp | Dentist | 302 E Lincoln, St Joseph, IL 61873 | 2006-09-05 |
| 1679676951 | Edmund Robert Rudnicke II | Dentist | 302 E Lincoln St, Saint Joseph, IL 61873 | 2006-09-05 |
| 1265618615 | Jmp Counseling and Tutoring Services, LLC | Counselor | 109 N. Main St., St. Joseph, IL 61873 | 2008-01-16 |
| 1942323282 | Bryan Myles Manion | Counselor | 109 N Main St, St Joseph, IL 61873 | 2007-04-10 |
| 1376635078 | Illini Christian Ministries Inc | Psychologist | 204 N Main St, Suite 203, Saint Joseph, IL 61873 | 2006-09-29 |
| 1558335703 | Troy Dean Branson | Chiropractor | 109 N Main, St Joseph, IL 61873-0028 | 2006-02-15 |
| 1417950387 | St. Joseph Drugs, Inc. | Pharmacist | 204 N. Main St., Saint Joseph, IL 61873-0500 | 2005-05-24 |
| 1285668830 | St. Joseph Drugs, Inc | Pharmacy | 204 N. Main, St. Joseph, IL 61873-0500 | 2006-07-10 |
| Find all providers in zip 61873 | ||||
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700199304 | College of St. Benedict | Clinic/Center | 37 College Ave S, Lottie Hall, Saint Joseph, MN 56374-2001 | 2010-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811409196 | Gavin School District 37 | Clinic/Center | 25775 W Highway 134, Ingleside, IL 60041-9587 | 2017-10-26 |
| 1053822080 | Northestern Illinois University Student Health Services | Clinic/Center | 5500 N Saint Louis Ave Rm E-051, Chicago, IL 60625-4625 | 2017-10-17 |
| 1871905190 | The Board of Trustees of The University of Illinois | Clinic/Center | 840 Blackhawk Blvd, South Beloit, IL 61080-2263 | 2014-05-21 |
| 1043630098 | Mcgaw Medical Center of Northwestern University | Clinic/Center | 240 E. Huron Street, Mcgaw Pavilion, Sutie 1-200, Chicago, IL 60611 | 2014-04-17 |
| 1407284664 | Pef Clinic II, Ltd. | Clinic/Center | 1955 E 75th St, Chicago, IL 60649-3688 | 2013-10-28 |
| 1508294091 | South Shore School of Leadership Health Center | Clinic/Center | 7627 S Constance Ave, Chicago, IL 60649-4009 | 2013-10-22 |
| 1659705150 | Circle Family Healthcare Network | Clinic/Center | 4701 Harrison St, Hillside, IL 60162-1616 | 2013-09-03 |
| 1932441946 | The Board of Trustees of Siu Governing Siue | Clinic/Center | Student Success Ctr Rm 0222, Campus Box 1055, Edwardsville, IL 62026-1055 | 2013-03-18 |
| 1225378094 | Kankakee School District 111 | Clinic/Center | 1200 W Jeffery St, Kankakee, IL 60901-4667 | 2013-02-15 |
| 1033478383 | Rockford School District | Clinic/Center | 401 N Gardiner Ave, Rockford, IL 61107-4338 | 2012-05-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOSEPH |
| Zip Code | 61873 |
Please comment or provide details below to improve the information on ST JOSEPH CCSD169.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.