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NPI Code Detail

MEDICARE: EGYPTIAN HEALTH DEPARTMENT

MEDICARE: EGYPTIAN HEALTH DEPARTMENT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QH0100XHealth Service Clinic/Center1002336IL
2261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)A-0271-0002-AIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
196505-00OTHERILIDHR NUMBER

General Provider Information

NPI Number : 1588662605
Entity Type Code : Organization
Provider Name (Legal Business Name) : EGYPTIAN HEALTH DEPARTMENT
Provider Business Mailing Address
First Line : 1412 US HIGHWAY 45 N
Second Line :
City : ELDORADO
State : IL
Zip : 62930-3766
Country : US
Telephone Number : 618-273-3326
Fax Number : 618-273-2808
Provider Business Practice Location Address
First Line : 1412 US HIGHWAY 45 N
Second Line :
City : ELDORADO
State : IL
Zip : 62930-3766
Country : US
Telephone Number : 618-273-3326
Fax Number : 618-273-2808
Authorized Official
Title or Position : CEO
Name : MRS. ANGIE HAMPTON
Credential :
Telephone Number : 618-273-3326
Provider Enumeration Date : 07/12/2005
Last Update Date : 02/03/2021

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Practice Location Address:
1412 US HIGHWAY 45 N
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Practice Fax: 618-273-2808
1427225481 — EGYPTIAN HEALTH DEPARTMENT
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1134396195 — EGYPTIAN PUBLIC AND MENTAL HEALTH DEPARTMENT
Practice Location Address:
1412 US HIGHWAY 45 N
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62930-3766
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Practice Fax: 618-273-2808
1144497108 — EGYPTIAN PUBLIC AND MENTAL HEALTH DEPARTMENT
Practice Location Address:
1412 US HIGHWAY 45 N
ELDORADO, IL
62930-3766
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Practice Fax: 618-273-2808
1649585407 — EGYPTIAN HEALTH DEPARTMENT
Practice Location Address:
1412 US HIGHWAY 45 N
ELDORADO, IL
62930-3766
Practice Phone: 618-273-3326
Practice Fax: 618-273-2808
1013287275 — DONNA K WHITE-LAND MSW, LCSW, QMHP
Practice Location Address:
1412 US HIGHWAY 45 N
ELDORADO, IL
62930-3766
Practice Phone: 618-273-3326
Practice Fax: 618-273-2808

Directions to “EGYPTIAN HEALTH DEPARTMENT ” Practice Location

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