Provider Demographics
NPI:1346481082
Name:WILL COUNTY HEALTH DEPT
Entity Type:Organization
Organization Name:WILL COUNTY HEALTH DEPT
Other - Org Name:BEHAVIORAL HEALTH - ACC
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLENEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-727-8480
Mailing Address - Street 1:501 ELLA AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60433-2799
Mailing Address - Country:US
Mailing Address - Phone:815-727-8480
Mailing Address - Fax:
Practice Address - Street 1:501 ELLA AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60433
Practice Address - Country:US
Practice Address - Phone:815-727-8480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILL COUNTY HEALTH DEPT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-03-10
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========011Medicaid