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Organization
COUNTY OF MERCER HOSPITAL
Active
Organization
COUNTY OF MERCER HOSPITAL
Active
Parent organization
COUNTY OF MERCER HOSPITAL
Other names
Medical Associates Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF MERCER HOSPITAL
Authorized official
TED ROGALSKI (CHIEF EXECUTIVE OFFICER)
(309) 582-3700
Entity
Organization
Contact information
Practice address
1007 NW 3RD ST, ALEDO, IL 61231-1296
(309) 582-3700
(309) 582-3737
Mailing address
1007 NW 3RD ST, ALEDO, IL 61231-1296
(309) 582-3700
(309) 582-3737
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006632002
BLUE CROSS OF IL
IL
01
—
210481
MEDICARE B
—
01
—
825050
MEDICARE B
IL
Enumeration date
07/10/2006
Last updated
02/25/2011
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