| Crusader Community Health South Beloit Junior High School | |
|
840 Blackhawk Blvd South Beloit IL 61080-2263 | |
| (815) 490-1600 | |
| Not Available |
| Full Name | Crusader Community Health South Beloit Junior High School |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 840 Blackhawk Blvd, South Beloit, Illinois |
| Authorized Official Name and Position | Samuel Miller (PRESDIENT & CEO) |
| Authorized Official Contact | 8154901737 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crusader Community Health South Beloit Junior High School 840 Blackhawk Blvd South Beloit IL 61080-2263 Ph: (815) 490-1600 | Crusader Community Health South Beloit Junior High School 840 Blackhawk Blvd South Beloit IL 61080-2263 Ph: (815) 490-1600 |
| NPI Number | 1346762390 |
|---|---|
| Provider Enumeration Date | 07/12/2017 |
| Last Update Date | 08/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346762390 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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South Beloit Office Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1407 Pate Plaza Dr, South Beloit, IL 61080 Phone: 630-219-2002 | |
Crusader Community Health South Beloit High School Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 245 Prairie Hill Rd, South Beloit, IL 61080 Phone: 815-490-1600 | |
University Clinic At South Beloit - Junior High Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 840 Blackhawk Blvd, South Beloit, IL 61080 Phone: 815-395-5861 Fax: 815-395-5575 |