| Tri County Sp Ed Jnt Agreement | |
|
114 S. 8th Street Elkville IL 62932-0130 | |
| (618) 568-1321 | |
| (618) 568-1152 |
| Full Name | Tri County Sp Ed Jnt Agreement |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 114 S. 8th Street, Elkville, Illinois |
| Authorized Official Name and Position | H. Rebecca Canty (SUPERINTENDENT) |
| Authorized Official Contact | 6185681321 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri County Sp Ed Jnt Agreement 114 S. 8th Street P.o. Box 130 Elkville IL 62924-0130 Ph: (618) 568-1321 | Tri County Sp Ed Jnt Agreement 114 S. 8th Street Elkville IL 62932-0130 Ph: (618) 568-1321 |
| NPI Number | 1841317500 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841317500 | NPI | - | NPPES |
| 376022272001 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (Illinois) | Primary |
Elverado Community Unit School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 South 8th Street, Elkville, IL 62932 Phone: 618-568-1321 |