# JERSEY COMMUNITY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JERSEY COMMUNITY HOSPITAL
- **Other names:** JCH Medical Group-Jerseyville III, East Annex, JCH Clinical Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1548744501
- **Legal business name:** JERSEY COMMUNITY HOSPITAL
- **Authorized official:** MICHELLE HOPPER (CFO)
- **Authorized official phone:** (618) 498-8349

## Contact information

- **Practice address:** 220 E COUNTY RD, JERSEYVILLE, IL 62052-3125
- **Practice address phone:** (618) 498-8467
- **Practice address fax:** (618) 639-2017
- **Mailing address:** 390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
- **Mailing address phone:** (618) 498-7518
- **Mailing address fax:** (618) 498-3052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | — |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/17/2018
- **Last updated:** 03/05/2025