Healthcare Provider Details

I. General information

NPI: 1942114251
Provider Name (Legal Business Name): SINNISSIPPI CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

524 W STEPHENSON ST
FREEPORT IL
61032-5057
US

IV. Provider business mailing address

524 W STEPHENSON ST
FREEPORT IL
61032-5057
US

V. Phone/Fax

Practice location:
  • Phone: 815-284-6611
  • Fax: 815-284-6642
Mailing address:
  • Phone: 815-284-6611
  • Fax: 815-284-6642

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: TERESA A GOOD
Title or Position: VP/CFO
Credential:
Phone: 815-284-6611