1306858154 NPI number — NATURAL FAMILY HEALTH S.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306858154 NPI number — NATURAL FAMILY HEALTH S.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NATURAL FAMILY HEALTH S.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306858154
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 240
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KINGSTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60145-0240
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
815-784-4554
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 N EMMETT ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GENOA
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60135-1087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
815-784-4554
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MOEGLING
Authorized Official First Name:
MARTHA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
815-784-4554

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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