Provider Demographics
NPI:1932114758
Name:COUNTY OF WILL
Entity Type:Organization
Organization Name:COUNTY OF WILL
Other - Org Name:WILL COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
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:815-727-8485
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:815-727-8484
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:815-727-8484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========004Medicaid
IL=========004Medicaid