| St Joseph Ccsd169 | |
|
409 S 5th St Saint Joseph IL 61873-9041 | |
| (217) 469-2291 | |
| (217) 469-8906 |
| Full Name | St Joseph Ccsd169 |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 409 S 5th St, Saint Joseph, Illinois |
| Authorized Official Name and Position | Todd Pence (SUPERINTENDENT) |
| Authorized Official Contact | 2174692291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St Joseph Ccsd169 Po Box 409 Saint Joseph IL 61873-0409 Ph: (217) 469-2291 | St Joseph Ccsd169 409 S 5th St Saint Joseph IL 61873-9041 Ph: (217) 469-2291 |
| NPI Number | 1689899288 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689899288 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |