SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP (NPI# 1306497052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306497052 |
| Entity Type | Organization |
| Organization Name | SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP |
| Practice Address |
1506 Sioux Dr Marion IL 62959-5209 |
| Mailing Address |
Po Box 577 109 California St Carterville IL 62918-0577 |
| Practice Telephone | 6185199200 |
| Practice Fax Number | 6185199155 |
| 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, Marion 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 |
1506 SIOUX DR |
| City | MARION |
| State | IL |
| Zip Code | 62959-5209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538150107 | Danneille C Trujillo-hansen | Clinical Nurse Specialist | 1506 Sioux Dr, Marion, IL 62959-5209 | 2005-11-02 |
| 1063991206 | Holly Ann Gates | Nurse Practitioner | 1506 Sioux Dr, Marion, IL 62959 | 2018-08-08 |
| 1134582471 | Tiffany Todd | Social Worker | 1506 Sioux Dr, Marion, IL 62959-5209 | 2016-04-04 |
| 1770770133 | Nicky R Turner | Nurse Practitioner | 1506 Sioux Dr, Marion, IL 62959 | 2007-10-01 |
| 1205036696 | Michael W Adams | Clinic/Center | 1506 Sioux Dr, Marion, IL 62959-5209 | 2007-07-23 |
| 1528178860 | Kathryn Marie Mcmurphy | Physician Assistant | 1506 Sioux Dr, Marion, IL 62959-5209 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710513486 | Sarah Benitone | Counselor | 11264 Il-37, Marion, IL 62959 | 2020-03-13 |
| 1528609328 | Patricia E Murphy | Radiology | 4503 1/2 W Deyoung, Suite 3a, Marion, IL 62959 | 2019-10-02 |
| 1366007007 | Centerstone of Illinois, Inc | Community/Behavioral Health | 202 S Bentley St, Marion, IL 62959 | 2019-05-08 |
| 1649752064 | Sydney Seiter | Occupational Therapist | 906 Skyline Suite 100, Marion, IL 62959 | 2018-09-01 |
| 1497279848 | Brooke Alisa Osman | Licensed Practical Nurse | 11531 Sunderland Road, Marion, IL 62959 | 2017-07-27 |
| 1912436429 | Joy L. Kee | Social Worker | 509 South Bentley Street, Marion, IL 62959 | 2017-06-08 |
| 1386181170 | Susan Smothers | Counselor | 1305 West Main Street, Marion, IL 62959 | 2017-01-31 |
| 1205280922 | Harish Kempegowda | Orthopaedic Surgery | 3331 W Deyoung St Ste 201, Marion, IL 62959 | 2016-04-19 |
| 1942609227 | Casey Hill | Social Worker | 1604 W. Walnut St., Marion, IL 62959 | 2014-08-22 |
| 1306252812 | Justin M White | Chiropractor | 1603 W Kimmel, Marion, IL 62959 | 2014-07-03 |
| Find all providers in zip 62959 | ||||
| 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 |
|---|---|---|---|---|
| 1932506359 | Cedar Valley Recovery Services Inc | Clinic/Center | 151 Marion Blvd, Marion, IA 52302-3135 | 2014-12-01 |
| 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 | ||||
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| 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.