MADISON COUNTY URBAN LEAGUE NPI 1174796734

NPI Information

  • NPI: 1174796734
  • Provider Name: MADISON COUNTY URBAN LEAGUE
  • Classification: Clinic/Center - 261Q00000X
  • Entity Type: Organization
  • Address: 500 MADISON AVE
    MADISON, IL
    ZIP 62060
  • Phone: (618) 876-9145

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NPI Details

MADISON COUNTY URBAN LEAGUE is a clinic center in Madison, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). MADISON COUNTY URBAN LEAGUE NPI is 1174796734. The provider is registered as an organization entity type.

The provider's business location address is:

500 MADISON AVE
MADISON, IL
ZIP 62060-414
Phone: (618) 876-9145
Fax: (618) 452-5392

The provider's authorized official is Ann Louise Walkington .
The authorized official title is Nurse and has the following contact phone number (618) 876-9145.

The enumeration date for this NPI number is 4/3/2008 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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