SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP


Address: 101 S Wall St, Carbondale, IL 62901-3021
Phone: 6185199200

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM2800X Clinic/Center
Specialization: Methadone Clinic
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Shawnee Health Care, OB/GYN SUD Doing Business As Name - Organization

Other Provider IDs and Locations

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

Office Location

Street Address 101 S WALL ST
City CARBONDALE
State IL
Zip Code 62901-3021

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 261QM2800X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Methadone Clinic

Taxonomy Definition

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]

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

Search similar providers

City CARBONDALE
Zip Code 62901

Improve Information

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Dataset Information

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.

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