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Organization
DECATUR MEMORIAL HOSPITAL
Active
Organization
DECATUR MEMORIAL HOSPITAL
Active
Other names
Professional Fees
Organization subpart
No
Provider details
NPI number
Authorized official
JUDI L HARLAN (NETWORK DEVELOPMENT AND PARTNERSHIP)
(217) 588-2882
Entity
Organization
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4192
(217) 876-8121
Mailing address
2300 N EDWARDS ST, MEDICAL STAFF OFFICE, DECATUR, IL 62526
(217) 876-2857
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
09/26/2022
Last updated
09/27/2022
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