Healthcare Provider Details

I. General information

NPI: 1154078673
Provider Name (Legal Business Name): CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2022
Last Update Date: 04/07/2025
Certification Date: 04/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 GAS PLANT RD
DU QUOIN IL
62832-3866
US

IV. Provider business mailing address

PO BOX 155
CHRISTOPHER IL
62822-0155
US

V. Phone/Fax

Practice location:
  • Phone: 618-790-2146
  • Fax: 618-790-2147
Mailing address:
  • Phone: 618-724-2401
  • Fax: 618-724-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: APRIL N KIEFER
Title or Position: CIO
Credential:
Phone: 618-724-1619