Provider Demographics
NPI:1275547820
Name:REGIONAL CARE ASSOCIATION
Entity Type:Organization
Organization Name:REGIONAL CARE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LANGEHENNIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:815-722-7000
Mailing Address - Street 1:72 N CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60432-4315
Mailing Address - Country:US
Mailing Address - Phone:815-722-7000
Mailing Address - Fax:815-722-7180
Practice Address - Street 1:72 N CHICAGO ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-4315
Practice Address - Country:US
Practice Address - Phone:815-722-7000
Practice Address - Fax:815-722-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL09932150OtherBCBS ILLINOIS #
IL205789Medicare ID - Type UnspecifiedAGENCY MEDICARE NUMBER