Provider Demographics
NPI:1871683110
Name:JO DAVIESS COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:JO DAVIESS COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MPH
Authorized Official - Phone:815-777-0263
Mailing Address - Street 1:9483 W US HIGHWAY 20
Mailing Address - Street 2:P O BOX 318
Mailing Address - City:GALENA
Mailing Address - State:IL
Mailing Address - Zip Code:61036-9182
Mailing Address - Country:US
Mailing Address - Phone:815-777-0263
Mailing Address - Fax:815-777-2977
Practice Address - Street 1:9483 W US HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:IL
Practice Address - Zip Code:61036-9182
Practice Address - Country:US
Practice Address - Phone:815-777-0263
Practice Address - Fax:815-777-2977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
548810Medicare ID - Type Unspecified