LIVINGSTON CO PUBLIC HLTH DEPT NPI 1235302308

NPI Information

NPI: 1235302308
Provider Name: LIVINGSTON CO PUBLIC HLTH DEPT

Other Name: PONTIAC TOWNSHIP HIGH SCHOOL SCHOOL BASE HEALTH CENTER

Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
1100 E INDIANA AVE
PONTIAC, IL
ZIP 61764
Phone: (815) 844-6113
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LIVINGSTON CO PUBLIC HLTH DEPT is a health service clinic center in Pontiac, IL. LIVINGSTON CO PUBLIC HLTH DEPT NPI is 1235302308. The provider is registered as an organization entity type.
The provider Other Name Is Pontiac Township High School School Base Health Center.

The provider's business location address is:

1100 E INDIANA AVE
PONTIAC, IL
ZIP 61764-204
Phone: (815) 844-6113
Fax: (815) 842-6517

The provider's authorized official is Malinda Hillman .
The authorized official title is Administrator and has the following contact phone number (815) 844-7174.

The enumeration date for this NPI number is 4/9/2008 and was last updated on 12/28/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	6176414	MEDICAID	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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