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General NPI Number Information
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NPI Number | 1134024268
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 215 N LOGAN ST
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City | WEST FRANKFORT
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State | IL
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Zip | 62896-2329
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Country | US
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Telephone | 618-923-7201
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Fax | 618-923-7202
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Provider Business Mailing Address
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Address Line | PO BOX 155
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City | CHRISTOPHER
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State | IL
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Zip | 62822-0155
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Country | US
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Telephone | 618-724-1602
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Fax | 855-634-9302
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Authorized Official
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Title or Position | CEO
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Name | KIMBERLY MITROKA
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Credential |
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Telephone | 618-724-1602
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State | NULL
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