SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP (NPI# 1902447196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902447196 |
Entity Type | Organization |
Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
Practice Address |
101 S Wall St Carbondale IL 62901-3021 |
Mailing Address |
Po Box 577 109 California St Carterville IL 62918-0577 |
Practice Telephone | 6185199200 |
Practice Fax Number | 6185199404 |
Mailing Telephone | 6185199200 |
Mailing Fax Number | 6189854635 |
Enumeration Date | 2019-09-30 |
Last Update Date | 2019-09-30 |
Authorized Official Name | PATSY R JENSEN (CEO) |
Authorized Official Telephone | 6189569508 |
Is Organization Subpart | Y |
Parent Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Shawnee Health Care, OB/GYN SUD | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053878967 | Shawnee Health Service and Development Corp | Clinic/Center | 1025 N Wall St Rm 102, Carbondale, IL 62901-1737 | 2019-02-27 |
1699232512 | Shawnee Health Service and Development Corp | Clinic/Center | 801 S Lewis Ln Rm 153, Carbondale, IL 62901-3408 | 2019-02-27 |
1487111639 | Shawnee Health Service and Development Corp | Clinic/Center | 121 N Parrish Ln Rm 123, Carbondale, IL 62901-2024 | 2019-02-25 |
1841757242 | Shawnee Health Service and Development Corp | Clinic/Center | 1150 E Grand Ave Rm 127, Carbondale, IL 62901-3422 | 2019-02-22 |
1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
1356677058 | Shawnee Health Service and Development Corp | Dentist | 3115 Williamson County Pkwy, Marion, IL 62959-5235 | 2009-10-30 |
1639295314 | Shawnee Health Service and Development Corp | Social Worker | 109 California St, Carterville, IL 62918-0577 | 2007-03-22 |
1326079245 | Shawnee Health Service and Development Corp | Clinic/Center | 1301 E Walnut St Rm J120, Carbondale, IL 62901-5004 | 2006-07-06 |
1881624161 | Shawnee Health Service and Development Corp | Clinic/Center | 1700 Wildcat Dr Ste A, Marion, IL 62959-1513 | 2006-07-03 |
1306497052 | Shawnee Health Service and Development Corp | Clinic/Center | 1506 Sioux Dr, Marion, IL 62959-5209 | 2019-09-24 |
Street Address |
101 S WALL ST |
City | CARBONDALE |
State | IL |
Zip Code | 62901-3021 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912908906 | Sherry L Jones | Obstetrics & Gynecology | 101 S Wall St, Carbondale, IL 62901 | 2005-08-02 |
1639797624 | Theresa Bainbridge | Advanced Practice Midwife | 101 S Wall St, Carbondale, IL 62901-3021 | 2020-07-07 |
1417590639 | Rachael Wernsman | Advanced Practice Midwife | 101 S Wall St, Carbondale, IL 62901-3021 | 2019-10-21 |
1275020992 | Laboratory Corporation of America | Clinical Medical Laboratory | 101 S Wall St, Carbondale, IL 62901 | 2018-04-18 |
1013464692 | Megan Walker | Advanced Practice Midwife | 101 S Wall St, Carbondale, IL 62901-3021 | 2016-09-01 |
1194272773 | Rebeccah Fletcher | Advanced Practice Midwife | 101 S Wall St, Carbondale, IL 62901-3021 | 2016-09-01 |
1124410972 | Miranda Leigh Saleh | Advanced Practice Midwife | 101 S Wall St, Carbondale, IL 62901 | 2015-03-03 |
1942620372 | Amanda J Bowers | Nurse Practitioner | 101 S Wall St, Carbondale, IL 62901-3021 | 2014-04-24 |
1013262666 | Jocelyn Alexandra Leon Peters | Obstetrics & Gynecology | 101 S Wall St, Carbondale, IL 62901-3021 | 2012-07-19 |
1881980233 | Izaskun Melania Iglesias | Pediatrics | 101 S Wall St, Carbondale, IL 62901-3021 | 2011-06-23 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
Find all providers in zip 62901 |
Taxonomy Code | 261QM2800X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Methadone Clinic |
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629629357 | Shawnee Health Service and Development Corp | Clinic/Center | 400 S Lewis Ln, Carbondale, IL 62901-3547 | 2019-09-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1245862457 | Jem Treatment, Inc | Clinic/Center | 2424 Washington St Ste Ll-110, Waukegan, IL 60085-5074 | 2020-02-05 |
1124659123 | Lake County Center, LLC | Clinic/Center | 310 S Greenleaf St Ste 206207, Gurnee, IL 60031-5708 | 2020-01-29 |
1750883286 | Buena Vista Group, LLC | Clinic/Center | 418 Dixie Hwy, Chicago Heights, IL 60411-1739 | 2018-02-28 |
1518485960 | The Bobby Buonauro Clinic | Clinic/Center | 1029 Howard St Ste 303, Evanston, IL 60202-3877 | 2017-09-06 |
1689196578 | Serenity Treatment and Counseling Center Inc | Clinic/Center | 19408 North Creek Drive, Lynwood, IL 60411-8649 | 2017-07-12 |
1699296129 | Loren 'half' Robinson Foundation | Clinic/Center | 4100 W Ogden Ave, Chicago, IL 60623-2821 | 2017-07-06 |
1942744453 | Recovery Concepts LLC | Clinic/Center | 17100 Dixie Hwy, Suite D & E, Hazel Crest, IL 60429-1485 | 2016-12-19 |
1184022303 | Renewed Hope Community Services Inc. | Clinic/Center | 626 E 71st St, Chicago, IL 60619-1212 | 2014-12-22 |
1316296007 | Sundance Methadone Treatment Center,llc | Clinic/Center | 4545 N Broadway St, 3rd Floor, Chicago, IL 60640-5975 | 2012-09-10 |
1790030344 | Ijegba Community Inc | Clinic/Center | 1950 E 75th St, Chicago, IL 60649-3633 | 2012-07-19 |
Find all providers with the same taxonomy |
City | CARBONDALE |
Zip Code | 62901 |
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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.