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SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
NPI 1629629357
Clinic/Center - Methadone in Carbondale, IL

Active since September 24, 2019
400 S LEWIS LN, CARBONDALE, IL 62901(618) 519-9200(618) 519-9961 Get Directions Write a Review

NPPES record last updated: September 24, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Shawnee Health Service And Development Corp NPPES

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

SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP (NPI 1629629357), doing business as Shawnee Health Care, Carbondale Sud, is a healthcare organization registered as a methadone in Carbondale, Illinois and active in the NPI registry since September 2019. The organization lists Patsy R Jensen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1629629357
Entity TypeOrganization
Primary Taxonomy261QM2800X
Legal Business NameSHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Location Address400 S LEWIS LNCarbondale, IL 62901-3547
Mailing AddressPo Box 577, 109 California StCarterville, IL 62918-0577 · (618) 519-9200 · Fax (618) 985-4635
Phone(618) 519-9200
Fax(618) 519-9961
Organization SubpartYes
Authorized OfficialPatsy R JensenCeo · (618) 956-9508
Enumeration DateSeptember 24, 2019
✔ NPI 1629629357 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · MethadoneAmbulatory Health Care Facilities
Taxonomy Code261QM2800X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.
400 S LEWIS LN, Carbondale, IL 62901
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Other Names 1

Doing Business AsShawnee Health Care, Carbondale Sud

Other Providers at the Same Location NPPES 16

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

POORVA TALAPATRA M.ED., LCPC
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
SHAWNEE HEALTH SERVICE AND DEVELOPMENT CORP
Clinic/Center (Federally Qualified Health Center (FQHC))
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
MRS. SARA HOYLE PA-C
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
LABORATORY CORPORATION OF AMERICA
Clinical Medical Laboratory
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 351-0016
MCKENZIE BONIFIELD
Nurse Practitioner (Family)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9200
TIFFANY D ALLEN LCPC
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9200
MICHAEL ROHLING MS, LCPC
Counselor (Mental Health)
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson County (618) 519-9900
MR. ETHAN WESHINSKEY PA-C
Physician Assistant
400 S LEWIS LN
CARBONDALE, IL 62901
Jackson 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 1629629357. It was assigned to this organization in the NPPES registry on September 24, 2019. The provider is doing business as Shawnee Health Care, Carbondale SUD.

Where is Shawnee Health Service And Development Corp located?

Shawnee Health Service And Development Corp is located at 400 S Lewis Ln, Carbondale, IL 62901. 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 Methadone, with taxonomy code 261QM2800X.

When was this NPI record last updated?

The NPPES record for Shawnee Health Service And Development Corp was last updated on September 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.