St. Charles | |
1750 E Main St Suite 40 St Charles IL 60174-2363 | |
(630) 513-6277 | |
Not Available |
Full Name | St. Charles |
---|---|
Speciality | Community/behavioral Health |
Location | 1750 E Main St, St Charles, Illinois |
Authorized Official Name and Position | Elizabeth Hopkins (CQIR MEDICAID COORDINATOR) |
Authorized Official Contact | 8472456556 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
St. Charles 1750 E Main St Suite 40 St Charles IL 60174-2363 Ph: (630) 513-6277 | St. Charles 1750 E Main St Suite 40 St Charles IL 60174-2363 Ph: (630) 513-6277 |
NPI Number | 1063748127 |
---|---|
Provider Enumeration Date | 10/26/2009 |
Last Update Date | 09/28/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1063748127 | NPI | - | NPPES |
2A00-IPI-004 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
253J00000X | Foster Care Agency | 37069157003 (Illinois) | Secondary |
News Archive
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