CENTRAL COUNTIES HEALTH CENTERS INC. NPI 1669520177

NPI Information

  • NPI: 1669520177
  • Provider Name: CENTRAL COUNTIES HEALTH CENTERS, INC.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CAPITOL COMMUNITY HEALTH CENTER - ST JOHN'S BREADLINE
  • CLIA Number: 14D0968767
  • Address: 430 N 5TH ST
    ST JOHN'S BREADLINE
    SPRINGFIELD, IL
    ZIP 62702
  • Phone: (217) 788-2300

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NPI Details

CENTRAL COUNTIES HEALTH CENTERS, INC. is a family medicine in Springfield, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. CENTRAL COUNTIES HEALTH CENTERS, INC. NPI is 1669520177. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Capitol Community Health Center - St John's Breadline.

The provider's business location address is:

430 N 5TH ST
ST JOHN'S BREADLINE
SPRINGFIELD, IL
ZIP 62702-202
Phone: (217) 788-2300
Fax: (217) 788-2343

The provider's authorized official is Cindy Kavanagh .
The authorized official title is Accountant and has the following contact phone number (217) 788-2300.

The CLIA number assigned to this NPI record is 14D0968767 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/8/2007 and was last updated on 9/21/2010.

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
1207R00000XInternal MedicineNo
2208000000XPediatricsNo
3207Q00000XFamily MedicineYes

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
1=========003MEDICAIDILLINOIS
2141964MEDICARE ID-TYPE UNSPECIFIEDILLINOIS

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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