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Organization
HSHS MEDICAL GROUP
Active
Organization
HSHS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD ROLSTAN M.D (PRESIDENT &CHIEF EXECUTIVE OFFICER)
(217) 523-4747
Entity
Organization
Contact information
Practice address
1900 E LAKE SHORE DR STE 330, SUITE 330, DECATUR, IL 62521-3848
(217) 423-2889
Mailing address
1900 E LAKE SHORE DR STE 330, SUITE 330, DECATUR, IL 62521-3848
(217) 423-2889
Taxonomy
Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
036125483
IL
Other
Enumeration date
06/07/2010
Last updated
09/07/2010
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