Provider Demographics
NPI:1063558328
Name:COUNTY OF VERMILION
Entity type:Organization
Organization Name:COUNTY OF VERMILION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-431-2662
Mailing Address - Street 1:200 S COLLEGE ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-6744
Mailing Address - Country:US
Mailing Address - Phone:217-431-2662
Mailing Address - Fax:217-431-7483
Practice Address - Street 1:200 S COLLEGE ST
Practice Address - Street 2:SUITE A
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-6744
Practice Address - Country:US
Practice Address - Phone:217-431-2662
Practice Address - Fax:217-431-7483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-063740261Q00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========004Medicaid
IL=========004Medicaid