# SPARROW IONIA HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SPARROW HEALTH SYSTEM
- **Other names:** University of Michigan Health-Sparrow Portland Primary Care, SMG PORTLAND
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1295801108
- **Legal business name:** SPARROW HEALTH SYSTEM
- **Authorized official:** MISTY GUNTER RUSSIAN (SUPERVISOR. PROVIDER ENROLLMENT)
- **Authorized official phone:** (517) 253-6308

## Contact information

- **Practice address:** 9751 E GRAND RIVER AVE, PORTLAND, MI 48875-9774
- **Practice address phone:** (517) 647-6722
- **Practice address fax:** (517) 647-6838
- **Mailing address:** 8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
- **Mailing address phone:** (616) 523-1400
- **Mailing address fax:** (616) 523-1429

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | 238631 | MI | Yes |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 03/11/2024