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Contact Information

CRUSADERS CENTRAL CLINIC ASSOCIATION
1050 LOGAN AVE
BELVIDERE, IL61008-3966
 Phone: 815-547-0282
 Fax: 815-490-1625
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Federally Qualified Health Center (FQHC)

261QF0400X B4[14] Federally Qualified Health Center
Indicates primary specialty

NPI Profile & details for CRUSADERS CENTRAL CLINIC ASSOCIATION

NPI Number 1780852244
LBN Legal business name CRUSADERS CENTRAL CLINIC ASSOCIATION
Authorized official SAMUEL MILLER - (PRESIDENT & CEO)
Entity Organization
Organization subpart 1 Yes
Enumeration date 02/18/2008
Last updated 08/24/2022 - About 4 years ago
Identifiers
Other 1011514778 BLUE CROSS BLUE SHIELD
Other 027548 CHAMPUS
IL Other 106483 DORAL
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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