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SHAWNEE HEALTH SOCIAL SERVICES
NPI 1053002907
Clinic/Center - Federally Qualified Health Center (FQHC) in Carterville, IL

Active since May 19, 2023
6355 BRANDHORST RD, CARTERVILLE, IL 62918(618) 519-9200(618) 985-9096 Get Directions Write a Review

NPPES record last updated: July 16, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 16, 2024, Apr 5, 2024, May 19, 2023 (3 updates tracked since 2023).

About Shawnee Health Social Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAWNEE HEALTH SOCIAL SERVICES (NPI 1053002907) is a healthcare organization registered as a federally qualified health center (fqhc) in Carterville, Illinois and active in the NPI registry since May 2023. The organization lists Christina Carney, Ceo, as its authorized official.

NPPES Registry Identity

NPI1053002907
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameSHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Location Address6355 BRANDHORST RDCarterville, IL 62918-3322
Mailing AddressPo Box 577Carterville, IL 62918-0577 · (618) 985-8221 · Fax (618) 985-6860
Phone(618) 519-9200
Fax(618) 985-9096
Organization SubpartYes
Authorized OfficialChristina CarneyCeo · (618) 956-9521
Enumeration DateMay 19, 2023
Last NPPES UpdateJuly 16, 20243 updates tracked since enumeration
NPPES CertifiedJuly 16, 2024
✔ NPI 1053002907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
Also ListedCounselor · Mental HealthTaxonomy 101YM0800X
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X
6355 BRANDHORST RD, Carterville, IL 62918
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Other Names 1

Doing Business AsShawnee Health Social Services

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RYAN ROGULICH LCSW
Social Worker (Clinical)
6355 BRANDHORST RD
CARTERVILLE, IL 62918
Williamson County (618) 519-9200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shawnee Health Service And Development Corp's NPI number?

The NPI number for Shawnee Health Service And Development Corp is 1053002907. It was assigned to this organization in the NPPES registry on May 19, 2023. The provider is doing business as Shawnee Health Social Services.

Where is Shawnee Health Service And Development Corp located?

Shawnee Health Service And Development Corp is located at 6355 Brandhorst Rd, Carterville, IL 62918. The listed phone number is (618) 519-9200.

What is Shawnee Health Service And Development Corp's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Shawnee Health Service And Development Corp was last updated on July 16, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.