Provider Demographics
NPI:1528203882
Name:COUNTY OF MONTGOMERY
Entity Type:Organization
Organization Name:COUNTY OF MONTGOMERY
Other - Org Name:MONTGOMERY COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HUGH
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTERLEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-532-2001
Mailing Address - Street 1:11191 ILLINOIS ROUTE 185
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:IL
Mailing Address - Zip Code:62049-2664
Mailing Address - Country:US
Mailing Address - Phone:217-532-2001
Mailing Address - Fax:217-532-6361
Practice Address - Street 1:11191 ILLINOIS ROUTE 185
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:IL
Practice Address - Zip Code:62049-2664
Practice Address - Country:US
Practice Address - Phone:217-532-2001
Practice Address - Fax:217-532-6361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicaid
IL329520Medicare PIN