SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP NPI 1457381774

NPI Information

  • NPI: 1457381774
  • Provider Name: SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
  • Classification: Clinic/Center - 261QF0400X
  • Specialization: Federally Qualified Health Center (FQHC)
  • Entity Type: Organization
  • Doing Business As: SHAWNEE HEALTH CARE, OB/GYN
  • Address: 101 S WALL ST
    CARBONDALE, IL
    ZIP 62901
  • Phone: (618) 519-9200

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NPI Details

SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP is a federally qualified health center (fqhc) clinic center in Carbondale, IL. SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP NPI is 1457381774. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Shawnee Health Care, Ob/gyn.

The provider's business location address is:

101 S WALL ST
CARBONDALE, IL
ZIP 62901-021
Phone: (618) 519-9200
Fax: (618) 519-9404

The provider's authorized official is Christina Carney .
The authorized official title is Ceo and has the following contact phone number (618) 956-9521.

The enumeration date for this NPI number is 7/3/2006 and was last updated on 7/29/2024.

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
1101YM0800XCounselorMental HealthNo
21041C0700XSocial WorkerClinicalNo
3207V00000XObstetrics & GynecologyNo
4261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110032052OTHERILLINOISBCBS
2CF3444OTHERILLINOISMEDICARE RAILROAD

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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