St Joseph Ccsd169 | |
409 S 5th St Saint Joseph IL 61873-9041 | |
(217) 469-2291 | |
(217) 469-8906 |
Full Name | St Joseph Ccsd169 |
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Speciality | Clinic/center - Student Health |
Location | 409 S 5th St, Saint Joseph, Illinois |
Authorized Official Name and Position | Todd Pence (SUPERINTENDENT) |
Authorized Official Contact | 2174692291 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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St Joseph Ccsd169 Po Box 409 Saint Joseph IL 61873-0409 Ph: (217) 469-2291 | St Joseph Ccsd169 409 S 5th St Saint Joseph IL 61873-9041 Ph: (217) 469-2291 |
NPI Number | 1689899288 |
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Provider Enumeration Date | 04/17/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1689899288 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |