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Organization
IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME
Active
Organization
IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME
Active
Other names
IMH Multi-Specialty Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
CHUCK BOHLMANN (PRESIDENT/CEO)
(815) 432-7736
Entity
Organization
Contact information
Practice address
200 LAIRD LN, WATSEKA, IL 60970-7568
(815) 432-5411
(815) 432-3955
Mailing address
200 LAIRD LN, WATSEKA, IL 60970-7568
(815) 432-5411
(815) 432-3955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
NULL
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/07/2006
Last updated
09/19/2014
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