SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP (NPI# 1235780982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235780982 |
| Entity Type | Organization |
| Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
| Practice Address |
1006 S Division St Carterville IL 62918-1539 |
| Mailing Address |
Po Box 577 109 California St Carterville IL 62918-0577 |
| Practice Telephone | 6185199200 |
| Practice Fax Number | 6189853774 |
| Mailing Telephone | 6185199200 |
| Mailing Fax Number | 6189854635 |
| Enumeration Date | 2019-09-24 |
| Last Update Date | 2019-09-24 |
| Authorized Official Name | PATSY R JENSEN (CEO) |
| Authorized Official Telephone | 6189569508 |
| Is Organization Subpart | Y |
| Parent Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Shawnee Health Care, Carterville SUD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053878967 | Shawnee Health Service and Development Corp | Clinic/Center | 1025 N Wall St Rm 102, Carbondale, IL 62901-1737 | 2019-02-27 |
| 1699232512 | Shawnee Health Service and Development Corp | Clinic/Center | 801 S Lewis Ln Rm 153, Carbondale, IL 62901-3408 | 2019-02-27 |
| 1487111639 | Shawnee Health Service and Development Corp | Clinic/Center | 121 N Parrish Ln Rm 123, Carbondale, IL 62901-2024 | 2019-02-25 |
| 1841757242 | Shawnee Health Service and Development Corp | Clinic/Center | 1150 E Grand Ave Rm 127, Carbondale, IL 62901-3422 | 2019-02-22 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1356677058 | Shawnee Health Service and Development Corp | Dentist | 3115 Williamson County Pkwy, Marion, IL 62959-5235 | 2009-10-30 |
| 1639295314 | Shawnee Health Service and Development Corp | Social Worker | 109 California St, Carterville, IL 62918-0577 | 2007-03-22 |
| 1326079245 | Shawnee Health Service and Development Corp | Clinic/Center | 1301 E Walnut St Rm J120, Carbondale, IL 62901-5004 | 2006-07-06 |
| 1881624161 | Shawnee Health Service and Development Corp | Clinic/Center | 1700 Wildcat Dr Ste A, Marion, IL 62959-1513 | 2006-07-03 |
| 1902447196 | Shawnee Health Service and Development Corp | Clinic/Center | 101 S Wall St, Carbondale, IL 62901-3021 | 2019-09-30 |
| Street Address |
1006 S DIVISION ST |
| City | CARTERVILLE |
| State | IL |
| Zip Code | 62918-1539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679548689 | Matin Nekzad | Family Medicine | 1006 S Division St, Carterville, IL 62918-1539 | 2006-02-22 |
| 1487111852 | Alexandria Markel | Counselor | 1006 S Division St, Carterville, IL 62918-1539 | 2019-02-21 |
| 1700373438 | Laboratory Corporation of America | Clinical Medical Laboratory | 1006 S Division St, Carterville, IL 62918 | 2018-04-18 |
| 1609381425 | Jacquelyn Batterman | Social Worker | 1006 S Division St, Carterville, IL 62918-1539 | 2017-12-04 |
| 1225584188 | Dominique M Williams | Counselor | 1006 S Division St, Carterville, IL 62918 | 2016-08-31 |
| 1275905374 | Laura Castillo | Nurse Practitioner | 1006 S Division St, Carterville, IL 62918-1539 | 2015-10-28 |
| 1952785222 | Amanda Reynolds | Nurse Practitioner | 1006 S Division St, Carterville, IL 62918-1539 | 2015-07-16 |
| 1326429242 | Kaif Mohammed Yusuf Mansuri | Family Medicine | 1006 S Division St, Carterville, IL 62918 | 2015-06-16 |
| 1801280573 | Yvonne Marchal | Social Worker | 1006 S Division St, Carterville, IL 62918 | 2015-03-20 |
| 1437571908 | Lab One LLC | Clinical Medical Laboratory | 1006 S Division St, Carterville, IL 62918-1539 | 2014-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670298 | Sherrie Ann Harlow | Social Worker | 117 Jeremy Drive, Caterville, IL 62918 | 2020-05-14 |
| 1457879330 | Alex M Witcher | Registered Nurse | 307 Pennsylvania Ave, Carterville, IL 62918 | 2017-08-31 |
| 1841650736 | Celena Lowes | Nurse Practitioner | 900 Logan College Road, Carterville, IL 62918 | 2016-03-04 |
| 1063895365 | Alexander J Ashby | Chiropractor | 1027 South Division Street, Carterville, IL 62918 | 2015-07-06 |
| 1902245095 | The H Group Bbt | Community/Behavioral Health | 403 Commerce Drive, Carterville, IL 62918 | 2013-06-21 |
| 1831311224 | Dental Professionals of Illinois, P.C. | Dentist | 809 South Division, Carterville, IL 62918 | 2007-05-03 |
| 1306067657 | Irene E. Knight | Speech-Language Pathologist | 122 Jeremy Drive, Carterville, IL 62918 | 2007-05-02 |
| 1104987940 | Solutions Counseling & Education Inc | Counselor | 209 W Commercial Dr, Suite H, Carterville, IL 62918 | 2006-12-13 |
| 1023078797 | Deepak Malhotra | Internal Medicine | 1400 Pin Oak Drive, Carterville, IL 62918 | 2006-03-25 |
| 1013362227 | Kristin Francis | Social Worker | 1400 Pin Oak Dr, Carterville, IL 62918 | 2016-04-26 |
| Find all providers in zip 62918 | ||||
| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862457 | Jem Treatment, Inc | Clinic/Center | 2424 Washington St Ste Ll-110, Waukegan, IL 60085-5074 | 2020-02-05 |
| 1124659123 | Lake County Center, LLC | Clinic/Center | 310 S Greenleaf St Ste 206207, Gurnee, IL 60031-5708 | 2020-01-29 |
| 1750883286 | Buena Vista Group, LLC | Clinic/Center | 418 Dixie Hwy, Chicago Heights, IL 60411-1739 | 2018-02-28 |
| 1518485960 | The Bobby Buonauro Clinic | Clinic/Center | 1029 Howard St Ste 303, Evanston, IL 60202-3877 | 2017-09-06 |
| 1689196578 | Serenity Treatment and Counseling Center Inc | Clinic/Center | 19408 North Creek Drive, Lynwood, IL 60411-8649 | 2017-07-12 |
| 1699296129 | Loren 'half' Robinson Foundation | Clinic/Center | 4100 W Ogden Ave, Chicago, IL 60623-2821 | 2017-07-06 |
| 1942744453 | Recovery Concepts LLC | Clinic/Center | 17100 Dixie Hwy, Suite D & E, Hazel Crest, IL 60429-1485 | 2016-12-19 |
| 1184022303 | Renewed Hope Community Services Inc. | Clinic/Center | 626 E 71st St, Chicago, IL 60619-1212 | 2014-12-22 |
| 1316296007 | Sundance Methadone Treatment Center,llc | Clinic/Center | 4545 N Broadway St, 3rd Floor, Chicago, IL 60640-5975 | 2012-09-10 |
| 1790030344 | Ijegba Community Inc | Clinic/Center | 1950 E 75th St, Chicago, IL 60649-3633 | 2012-07-19 |
| Find all providers with the same taxonomy | ||||
| City | CARTERVILLE |
| Zip Code | 62918 |
Please comment or provide details below to improve the information on SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.