Provider Demographics
NPI:1255499463
Name:SOUTHERN SEVEN HEALTH DEPT
Entity Type:Organization
Organization Name:SOUTHERN SEVEN HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS-RAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-634-2297
Mailing Address - Street 1:37 RUSTIC CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:ULLIN
Mailing Address - State:IL
Mailing Address - Zip Code:62992-2226
Mailing Address - Country:US
Mailing Address - Phone:618-634-2297
Mailing Address - Fax:618-634-9011
Practice Address - Street 1:37 RUSTIC CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ULLIN
Practice Address - State:IL
Practice Address - Zip Code:62992-2226
Practice Address - Country:US
Practice Address - Phone:618-634-2297
Practice Address - Fax:618-634-9011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL600001850OtherRAILROAD MEDICARE-MASSAC
IL600001853OtherRAILROAD MEDICARE-POPE CO
IL600001837OtherRAILROAD MEDICARE-ALEX CO
IL600001852OtherRAILROAD MEDICARE-HARDIN
IL010017185OtherRAILROAD MEDICARE-PULASKI
IL600001836OtherRAILROAD MEDICARE - UNION COUNTY
IL600001851OtherRAILROAD MEDICARE-JOHNSON
IL600001852OtherRAILROAD MEDICARE-HARDIN
IL381970Medicare ID - Type UnspecifiedALEXANDER CO PH
IL382000Medicare PIN
IL600001837OtherRAILROAD MEDICARE-ALEX CO
IL381980Medicare ID - Type UnspecifiedHARDIN CO PH
IL=========002Medicaid
IL010017185OtherRAILROAD MEDICARE-PULASKI
IL600001852OtherRAILROAD MEDICARE-HARDIN