Provider Demographics
NPI:1447459110
Name:WINNEBAGO COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:WINNEBAGO COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN, DNP
Authorized Official - Phone:815-720-4210
Mailing Address - Street 1:PO BOX 4009
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61110-0509
Mailing Address - Country:US
Mailing Address - Phone:815-720-4000
Mailing Address - Fax:815-720-4001
Practice Address - Street 1:555 N COURT ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61103-6862
Practice Address - Country:US
Practice Address - Phone:815-720-4200
Practice Address - Fax:815-720-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========003MedicaidKIDCARE