# KATHERINE SHAW BETHEA HOSPITAL-SNU

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447245147
- **Authorized official:** MR. VERNON FARRELL (VICE PRESIDENT OF FINANCE)
- **Authorized official phone:** (815) 285-5511

## Contact information

- **Practice address:** 403 E 1ST ST, DIXON, IL 61021-3116
- **Practice address phone:** (815) 288-5531
- **Mailing address:** 403 E 1ST ST, DIXON, IL 61021-3116
- **Mailing address phone:** (815) 288-5531

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 273Y00000X | Rehabilitation Hospital Unit | 0000497 | IL | Yes |

## Other

- **Enumeration date:** 09/19/2005
- **Last updated:** 08/22/2020