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General NPI Number Information
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NPI Number | 1366693632
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Entity Type | Organization
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Legal Business Name | CHAMPAIGN URBANA PUBLIC HEALTH DEPARTMENT
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Dates
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Enumeration Date | 10/06/2008
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Last Update Date | 10/06/2008
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Provider Practice Location Address
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Address Line | 201 W KENYON RD
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City | CHAMPAIGN
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State | IL
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Zip | 61820-7807
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Country | US
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Telephone | 217-531-4279
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Fax | 217-531-4333
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Provider Business Mailing Address
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Address Line | 201 W KENYON RD
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City | CHAMPAIGN
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State | IL
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Zip | 61820-7807
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Country | US
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Telephone | 217-531-4279
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Fax | 217-531-4333
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Authorized Official
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Title or Position | INTERIM ADMINITRATOR
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Name | MS. JULIE PRYDE
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Credential |
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Telephone | 217-531-5369
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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 | 251K00000X
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License Number State | IL
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