JEFFERSON COUNTY COMPREHENSIVE (NPI# 1972533990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972533990 |
| Entity Type | Organization |
| Organization Name | JEFFERSON COUNTY COMPREHENSIVE |
| Practice Address |
16342 N Il Hwy 37 Mt Vernon IL 62864 |
| Mailing Address |
Po Box 428 Mt Vernon IL 62864 |
| Practice Telephone | 6182421510 |
| Practice Fax Number | 6182420958 |
| Mailing Telephone | 6182421510 |
| Mailing Fax Number | 6182420958 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2015-12-09 |
| Authorized Official Name | MR. DAN BOEHMER (C.E.O.) |
| Authorized Official Telephone | 6182421510 |
| Authorized Official Credential | C.E.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0004115177 | 01 |
| MAGELLAN | 497770000 | 01 | |
| HEALTHLINK | 372631 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649404708 | Jefferson County Comprehensive | Community/Behavioral Health | 16338 N Il Hwy 37, Mt Vernon, IL 62864 | 2009-05-05 |
| Street Address |
16342 N IL HWY 37 |
| City | MT VERNON |
| State | IL |
| Zip Code | 62864 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437494002 | Brent Simpson | Counselor | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2012-12-07 |
| 1255676227 | Erin Wenzel | Licensed Practical Nurse | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2012-12-03 |
| 1184978413 | James Kellerman | Counselor | 16342 N Il Hwy 37, Mt Vernon, IL 62864-0054 | 2012-11-08 |
| 1457610719 | Lisa B Korzenewski | Registered Nurse | 16342 N Il Hwy 37, Mt Vernon, IL 62864-0054 | 2012-05-08 |
| 1699003293 | Lorianne Catherine Schmider | Counselor | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2009-11-20 |
| 1881828788 | Jefferson County Comprehensive Svc | Clinic/Center | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2009-05-06 |
| 1629181573 | Sherry Gail Webb | Licensed Practical Nurse | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2006-08-16 |
| 1700999661 | Loretta M Stevens | Registered Nurse | 16342 N Il Hwy 37, Mt Vernon, IL 62862 | 2006-08-16 |
| 1760404545 | Jane E Williams | Counselor | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2006-07-24 |
| 1679595458 | Larry W Knopp | Counselor | 16342 N Il Hwy 37, Mt Vernon, IL 62864 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639990 | Mindy Forman, Psyd, LLC | Clinic/Center | 1020 Milwaukee Ave Ste 110, Deerfield, IL 60015-3555 | 2020-11-07 |
| 1346840295 | Stopka Professional Counseling LLC | Clinic/Center | 13125 Steeplechase Dr, New Lenox, IL 60451-1320 | 2020-10-29 |
| 1346848785 | Wellness Hearted Therapy LLC | Clinic/Center | 2675 S Cedar Glen Dr, Arlington Heights, IL 60005-5303 | 2020-10-16 |
| 1457959256 | Association for Individual Development | Clinic/Center | 708 N Bridge St, Yorkville, IL 60560-1105 | 2020-10-14 |
| 1285231555 | Association for Individual Development | Clinic/Center | 236 W Crystal Lake Ave, Crystal Lake, IL 60014-5847 | 2020-10-08 |
| 1386241123 | Envision Unlimited | Clinic/Center | 1801 N Spaulding Ave, Chicago, IL 60647-4926 | 2020-10-05 |
| 1881291789 | Jessica Weisbach, LLC | Clinic/Center | 2257 N Kedzie Blvd Apt 3, Chicago, IL 60647-2561 | 2020-10-04 |
| 1619574803 | Envision Unlimited | Clinic/Center | 2124 W 82nd Pl, Chicago, IL 60620-5358 | 2020-10-01 |
| 1144827320 | Envision Unlimited | Clinic/Center | 4919 N Clark St, Chicago, IL 60640-3514 | 2020-10-01 |
| 1194322370 | Envision Unlimited | Clinic/Center | 4911 S Hoyne Ave, Chicago, IL 60609-4721 | 2020-10-01 |
| 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.