Provider Demographics
NPI:1225167455
Name:PLANNED PARENTHOOD OF DECATUR, INC.
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF DECATUR, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANI
Authorized Official - Middle Name:HUSTON
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:BS, APN, CNP
Authorized Official - Phone:217-877-6474
Mailing Address - Street 1:3021 N OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1607
Mailing Address - Country:US
Mailing Address - Phone:217-877-6474
Mailing Address - Fax:217-877-9452
Practice Address - Street 1:3021 N OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1607
Practice Address - Country:US
Practice Address - Phone:217-877-6474
Practice Address - Fax:217-877-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0005832073OtherBLUE CROSSBLUE SHIELD
IL0005832073OtherBLUE CROSSBLUE SHIELD