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General NPI Number Information
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NPI Number | 1174277610
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Entity Type | Organization
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Legal Business Name | COUNTY OF TAZEWELL
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Dates
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Enumeration Date | 02/03/2022
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 21306 STATE ROUTE 9
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City | TREMONT
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State | IL
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Zip | 61568-9252
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Country | US
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Telephone | 309-925-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 21306 STATE ROUTE 9
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City | TREMONT
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State | IL
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Zip | 61568-9252
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Country | US
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Telephone | 309-925-5511
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Fax |
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Authorized Official
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Title or Position | BILLING COORDINATOR
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Name | SHANNON RISCH
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Credential |
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Telephone | 309-925-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number |
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License Number State |
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