Healthcare Provider Details

I. General information

NPI: 1528008034
Provider Name (Legal Business Name): COUNTY OF WHITESIDE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 W 2ND ST
ROCK FALLS IL
61071-1005
US

IV. Provider business mailing address

1300 W 2ND ST
ROCK FALLS IL
61071-1005
US

V. Phone/Fax

Practice location:
  • Phone: 815-626-2230
  • Fax: 815-626-2231
Mailing address:
  • Phone: 815-626-2230
  • Fax: 815-626-2231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL
# 5
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: CHERYL L LEE
Title or Position: PHA/CEO
Credential:
Phone: 815-626-2230