Provider Demographics
NPI:1346416609
Name:WHITESIDE COUNTY COURT SERVICES
Entity Type:Organization
Organization Name:WHITESIDE COUNTY COURT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-772-5119
Mailing Address - Street 1:200 E KNOX ST
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:IL
Mailing Address - Zip Code:61270-2809
Mailing Address - Country:US
Mailing Address - Phone:815-772-5119
Mailing Address - Fax:815-772-2917
Practice Address - Street 1:200 E KNOX ST
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:IL
Practice Address - Zip Code:61270-2809
Practice Address - Country:US
Practice Address - Phone:815-772-5119
Practice Address - Fax:815-772-2917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management