CRUSADERS CENTRAL CLINIC ASSOCIATION

NPI # 

Practice Address:

2704 N Main St

Rockford, IL, 61103-3112

Practice Phone:

815-490-1600

Practice Fax:

815-490-1845

License State:

IL

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X

Deactivation Date:

2022-02-25T00:00:00.000Z

Deactivation Code:

None

Reactivation Date:

2023-08-08T00:00:00.000Z