CRUSADERS CENTRAL CLINIC ASSOCIATION NPI 1891082194

NPI Information

NPI: 1891082194
Provider Name: CRUSADERS CENTRAL CLINIC ASSOCIATION

Doing Business As: CRUSADER COMMUNITY HEALTH

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
6115 N 2ND ST
LOVES PARK, IL
ZIP 61111
Phone: (815) 490-1600
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CRUSADERS CENTRAL CLINIC ASSOCIATION is a federally qualified health center (fqhc) clinic center in Loves Park, IL. CRUSADERS CENTRAL CLINIC ASSOCIATION NPI is 1891082194. The provider is registered as an organization entity type.
The provider Is Doing Business As Crusader Community Health.

The provider's business location address is:

6115 N 2ND ST
LOVES PARK, IL
ZIP 61111-155
Phone: (815) 490-1600
Fax: (815) 490-1625

The provider's authorized official is Samuel Miller .
The authorized official title is President And Ceo and has the following contact phone number (815) 490-1737.

The enumeration date for this NPI number is 7/7/2011 and was last updated on 8/24/2022.

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
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			Yes

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: 5/5/2024

NPI Synchronization or Removal

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