Healthcare Provider Details

I. General information

NPI: 1063558328
Provider Name (Legal Business Name): COUNTY OF VERMILION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 05/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S COLLEGE ST SUITE A
DANVILLE IL
61832-6744
US

IV. Provider business mailing address

200 S COLLEGE ST SUITE A
DANVILLE IL
61832-6744
US

V. Phone/Fax

Practice location:
  • Phone: 217-431-2662
  • Fax: 217-431-7483
Mailing address:
  • Phone: 217-431-2662
  • Fax: 217-431-7483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number036-063740
License Number StateIL

VIII. Authorized Official

Name: DONNA J DUNHAM
Title or Position: FINANCIAL DIRECTOR
Credential:
Phone: 217-431-2662