Healthcare Provider Details

I. General information

NPI: 1104887801
Provider Name (Legal Business Name): CASS COUNTY PUBLIC HEALTH DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 S MAIN ST
VIRGINIA IL
62691-1519
US

IV. Provider business mailing address

331 S MAIN ST
VIRGINIA IL
62691-1571
US

V. Phone/Fax

Practice location:
  • Phone: 217-452-3057
  • Fax: 217-452-7245
Mailing address:
  • Phone: 217-452-3057
  • Fax: 217-452-7245

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. TIFFANY ANGELO
Title or Position: ADMINISTRATOR
Credential: RN, BSN
Phone: 217-452-3057