institution
Crusaders Central Clinic Association
Federally Qualified Health Center (FQHC) in Rockford, Illinois
NPI 1902972557

Crusaders Central Clinic Association is a Federally Qualified Health Center (FQHC) based in Rockford, IL and is specialized in Federally Qualified Health Center (FQHC). Crusaders Central Clinic Association practices in Rockford, IL. The NPI Number for Crusaders Central Clinic Association is 1902972557 and holds a License No. (Illinois).

The current practice location address for Crusaders Central Clinic Association is 1200 W State St, Rockford, IL and can be reached out via phone at 815-490-1600.

Location: 1200 W State St, Rockford, IL, 61102-2112
institution
Provider Profile Details
NPI Number
1902972557
Provider Name
Crusaders Central Clinic Association
Credential
Provider Entity Type
Organization
Address
1200 W State St, Rockford, IL, 61102-2112
Phone Number
815-490-1600
Fax Number
Provider Enumeration Date
11/27/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
027548 01 CHAMPUS
101-15147-78 01 BLUE CROSS BLUE SHIELD
101319 01 IL DORAL
institution
Provider Business Practice Location Address Details
Address
1200 W State St
City
State
Zip
61102-2112
Phone Number
815-490-1600
Fax Number
person
Provider Business Mailing Address Details
Address
1200 W State St
City
State
Zip
61102-2112
Phone Number
815-490-1600
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
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Definition
Definition to come...
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