| Organization Name: | COUNTY OF MENARD |
| NPI Number: | 1528106812 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ALICIA DAVIS (ADMINISTRATOR) |
| Mailing Address: | 1120 N 4th St Suite A Petersburg |
| State: | IL US |
| Postal Code: | 626751115 |
| Phone Number: | 2176323283 |
| Fax Number: | 2176323675 |
| NPI Enumeration Date: | 02/01/2007 |
| NPI Last Update Date: | 10/28/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251K00000X |
| License Number: | ========= |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Public Health or Welfare |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |