OrganizationActive
Shawnee Health Service and Development Corp
NPI 1356677058 · Federally Qualified Health Center (FQHC) · Marion, IL
Provider details
- NPI number
- 1356677058
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Shawnee Health Service and Development Corp
- Organization subpart
- Yes
- Authorized official
- Christina Carney, Ceo(618) 956-9521
Specialties & taxonomies
Ambulatory Health Care Facilities
- Pediatric Dentistry1223P0221X
Dental Providers
- Dental Hygienist124Q00000X
Dental Providers
- Dental Assistant126800000X
Dental Providers
- Dentist122300000X
Dental Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
3115 Williamson County Pkwy
Marion, IL 62959-5235
Phone: (618) 969-8600
Fax: (618) 997-1214
Street-level locationGet directions
Mailing address
109 California Street
Carterville, IL 62918-0577
Other names (DBA / former)
- Doing business as
- Shawnee Health Care, Marion Dental
- Doing business as
- Shawnee Health, Children'S Dental Center - General Care
Registry dates
- Enumerated
- 2009-10-30
- Last updated
- 2025-12-10
- Certified
- 2025-12-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.