Provider Demographics
NPI:1639654411
Name:CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT
Entity Type:Organization
Organization Name:CHAMPAIGN URBANA PUBLIC HEALTH DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-531-4263
Mailing Address - Street 1:201 W KENYON RD
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61820-7892
Mailing Address - Country:US
Mailing Address - Phone:217-531-4263
Mailing Address - Fax:217-531-5382
Practice Address - Street 1:201 W KENYON RD
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7892
Practice Address - Country:US
Practice Address - Phone:217-352-7961
Practice Address - Fax:217-531-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management