Organization
ST MARYS HOSPITAL SISTERS OF THE THIRD ORDER OF ST FRANCIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D EVARD (VP OF REVENUE CYCLE)
(217) 492-9651
Entity
Organization
Contact information
Practice address
1800 E LAKE SHORE DR, DECATUR, IL 62521-3883
(217) 464-2590
Mailing address
3051 HOLLIS DR, SPRINGFIELD, IL 62704-7450
(217) 464-2590
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140166
MEDICARE
IL
Enumeration date
06/01/2018
Last updated
09/19/2023
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