# ST JOHNS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ST. JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
- **Other names:** Medicaid outpatient number for 2360 forms
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1265414015
- **Legal business name:** ST. JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
- **Authorized official:** MARK DUANE EVARD (VP OF REVENUE CYCLE)
- **Authorized official phone:** (217) 492-9651

## Contact information

- **Practice address:** 800 EAST CARPENTER, SPRINGFIELD, IL 62769-0001
- **Practice address phone:** (217) 544-6464
- **Practice address fax:** (217) 535-3989
- **Mailing address:** 3051 HOLLIS DR, SPRINGFIELD, IL 62704-7450
- **Mailing address phone:** (217) 544-6464
- **Mailing address fax:** (217) 535-3989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 0002451 | IL | Yes |

## Other

- **Enumeration date:** 11/17/2005
- **Last updated:** 08/14/2024