Provider Demographics
NPI:1306017462
Name:BOND COUNTY
Entity Type:Organization
Organization Name:BOND COUNTY
Other - Org Name:BOND COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EIFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:618-664-1442
Mailing Address - Street 1:1520 SOUTH 4TH STREET
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62246-2618
Mailing Address - Country:US
Mailing Address - Phone:618-684-1442
Mailing Address - Fax:618-664-1744
Practice Address - Street 1:1520 SOUTH 4TH STREET
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:IL
Practice Address - Zip Code:62246-2618
Practice Address - Country:US
Practice Address - Phone:618-664-1442
Practice Address - Fax:618-664-1744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-17
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251K00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL613422Medicare PIN
IL613422Medicare PIN