Provider Demographics
NPI:1174277610
Name:COUNTY OF TAZEWELL
Entity Type:Organization
Organization Name:COUNTY OF TAZEWELL
Other - Org Name:TAZEWELL COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:RISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-925-5511
Mailing Address - Street 1:21306 STATE ROUTE 9
Mailing Address - Street 2:
Mailing Address - City:TREMONT
Mailing Address - State:IL
Mailing Address - Zip Code:61568-9252
Mailing Address - Country:US
Mailing Address - Phone:309-925-5511
Mailing Address - Fax:
Practice Address - Street 1:21306 STATE ROUTE 9
Practice Address - Street 2:
Practice Address - City:TREMONT
Practice Address - State:IL
Practice Address - Zip Code:61568-9252
Practice Address - Country:US
Practice Address - Phone:309-925-5511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF TAZEWELL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-03
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No251K00000XAgenciesPublic Health or Welfare
No261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or LocalGroup - Single Specialty