# JULIA RACKLEY PERRY MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** JULIA RACKLEY PERRY MEMORIAL HOSPITAL
- **Other names:** PMH Anesthesia
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1891752010
- **Legal business name:** JULIA RACKLEY PERRY MEMORIAL HOSPITAL
- **Authorized official:** MS. JEAN WELTE (MEDICAL STAFF SERVICES COORDINATOR)
- **Authorized official phone:** (815) 876-2293

## Contact information

- **Practice address:** 530 PARK AVE E, PRINCETON, IL 61356-3901
- **Practice address phone:** (815) 875-2811
- **Practice address fax:** (815) 876-4455
- **Mailing address:** 530 PARK AVE E, PRINCETON, IL 61356-3901
- **Mailing address phone:** (815) 875-2811
- **Mailing address fax:** (815) 876-4455

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |
| 367500000X | Certified Registered Nurse Anesthetist | — | NULL | — |
| 367500000X | Certified Registered Nurse Anesthetist | — | — | — |

## Other

- **Enumeration date:** 05/01/2006
- **Last updated:** 03/06/2020