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Organization
HSHS HOLY FAMILY HOSPITAL INC
Active
Organization
HSHS HOLY FAMILY HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DUANE EVARD (VP OF REVENUE CYCLE)
(217) 492-9651
Entity
Organization
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-0808
(618) 664-9750
Mailing address
3051 HOLLIS DR, SPRINGFIELD, IL 62704-7450
(618) 664-0808
(618) 664-9750
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0005355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310338
BLUECROSS BLUESHIELD
—
01
—
CA3883
MEDICARE RAILROAD
—
Enumeration date
07/24/2006
Last updated
10/31/2024
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