Johnston City Community Health Center is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Johnston City, Illinois. The current practice location for Johnston City Community Health Center is 14410 Route 37, Johnston City Community Health Center, Johnston City, Illinois. For appointments, you can reach them via phone at
(618) 983-6911. The mailing address for Johnston City Community Health Center is Po Box 155, Christopher, Illinois and phone number is (618) 724-2401.
Johnston City Community Health Center is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its
NPI number is 1053593533. This medical practice
accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at
(618) 983-6911.
Primary Care Clinic Profile
| Full Name | Johnston City Community Health Center |
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| Speciality | Clinic/Center |
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| Location | 14410 Route 37, Johnston City, Illinois |
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| Authorized Official Name and Position | Kim A. Mitroka (PRESIDENT/ C.E.O.) |
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| Authorized Official Contact | 6187242401 |
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| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
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Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Johnston City Community Health Center
Po Box 155
Christopher
IL 62822-0155
Ph: (618) 724-2401 | Johnston City Community Health Center
14410 Route 37
Johnston City Community Health Center
Johnston City
IL 62951
Ph: (618) 983-6911 |
NPI Details:
| NPI Number | 1053593533 |
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| Provider Enumeration Date | 11/27/2007 |
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| Last Update Date | 01/25/2019 |
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Medicare PECOS Information:
| Medicare PECOS PAC ID | 8224947387 |
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| Medicare Enrollment ID | O20080207000259 |
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Medical Identifiers
Medical identifiers for Johnston City Community Health Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053593533 | NPI | - | NPPES |
| 036049529 | Medicaid | IL | |
| 036049529 | Other | IL | COMMUNITY HEALTH CENTER |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
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