Provider Demographics
NPI:1871769802
Name:COUNTY OF JO DAVIESS
Entity type:Organization
Organization Name:COUNTY OF JO DAVIESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PEGGY
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN,MPH
Authorized Official - Phone:815-777-0263
Mailing Address - Street 1:9483 ROUTE 20 W
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:IL
Mailing Address - Zip Code:61036-9182
Mailing Address - Country:US
Mailing Address - Phone:815-777-0593
Mailing Address - Fax:181-577-7297
Practice Address - Street 1:9483 ROUTE 20 W
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:IL
Practice Address - Zip Code:61036-9182
Practice Address - Country:US
Practice Address - Phone:815-777-0593
Practice Address - Fax:181-577-7297
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAMILY PLANNING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare