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NPI Code Detail

MEDICARE: COUNTY OF HENRY

MEDICARE: COUNTY OF HENRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker
2251K00000XPublic Health or Welfare Agency
3253Z00000XIn Home Supportive Care Agency
4261QF0050XNon-Surgical Family Planning Clinic/Center
5261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
6261QP0905XState or Local Public Health Clinic/Center

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DH1819OTHERILMEDICARE RR
3241300OTHERILMEDICARE PART B

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
23721776OTHERILBCBS

General Provider Information

NPI Number : 1851394829
Entity Type Code : Organization
Provider Name (Legal Business Name) : COUNTY OF HENRY
Provider Business Mailing Address
First Line : 110 N BURR BLVD
Second Line :
City : KEWANEE
State : IL
Zip : 61443-2214
Country : US
Telephone Number : 309-852-0197
Fax Number : 98-545-5753
Provider Business Practice Location Address
First Line : 110 N BURR BLVD
Second Line :
City : KEWANEE
State : IL
Zip : 61443-2214
Country : US
Telephone Number : 309-852-0197
Fax Number : 98-545-5753
Authorized Official
Title or Position : INSURANCE BILLING
Name : TARA LAFOLLETTE
Credential :
Telephone Number : 309-852-0197
Provider Enumeration Date : 05/24/2005
Last Update Date : 04/28/2025

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Directions to “COUNTY OF HENRY ” Practice Location

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