Organization
MENDOTA COMMUNITY HOSPITAL
Active
Other names
OSF Medical Group-Mendota, Physician Services of MCH
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C. SEHRING (CEO, OSF HEALTHCARE SYSTEM)
(306) 655-2850
Entity
Organization
Contact information
Practice address
1401 EAST 12TH STREET, MENDOTA, IL 61342-9216
(815) 539-7461
(815) 538-5516
Mailing address
124 SW ADAMS ST, PEORIA, IL 61602-1320
(093) 655-2850
(309) 655-4878
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0001537
IL
207X00000X
Orthopaedic Surgery Physician
0001537
IL
208600000X
Surgery Physician
0001537
IL
363A00000X
Physician Assistant
0001537
IL
363L00000X
Nurse Practitioner
0001537
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CI2549
RAILROAD MEDICARE
—
Enumeration date
07/15/2006
Last updated
03/18/2024
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