Organization
SOUTHERN ILLINOIS HOSPITAL SERVICES
Active
Other names
Memorial Hospital of Carbondale
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON HARTKE MBA, CHFP (CORPORATE DIRECTOR, PATIENT FINANCI)
(618) 457-5200
Entity
Organization
Contact information
Practice address
405 W JACKSON, CARBONDALE, IL 62901-1000
(618) 457-5200
Mailing address
1239 E. MAIN, PO BOX 3988, CARBONDALE, IL 62901-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0000513
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000513
STATE OF IL LICENSE NUMBE
IL
Enumeration date
10/04/2006
Last updated
02/05/2013
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