Basic Information
| Provider Information | |||||||||
| NPI: | 1831395581 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | KENDALL COUNTY HEALTH DEPARTMENT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 811 W JOHN ST | ||||||||
| Address2: | |||||||||
| City: | YORKVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605609249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305539100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 811 W JOHN ST | ||||||||
| Address2: | |||||||||
| City: | YORKVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605609249 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6305539100 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2007 | ||||||||
| LastUpdateDate: | 07/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | JOHNSON | ||||||||
| AuthorizedOfficialFirstName: | CHERYL | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 6305539100 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | B.A. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | Y | Agencies | Community/Behavioral Health |
No ID Information.