Organization
JERSEY COMMUNITY HOSPITAL
Active
Parent organization
JERSEY COMMUNITY HOSPITAL
Other names
JCH Medical Group-Jerseyville III, East Annex, JCH Clinical Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
JERSEY COMMUNITY HOSPITAL
Authorized official
MICHELLE HOPPER (CFO)
(618) 498-8349
Entity
Organization
Contact information
Practice address
220 E COUNTY RD, JERSEYVILLE, IL 62052-3125
(618) 498-8467
(618) 639-2017
Mailing address
390 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2000
(618) 498-7518
(618) 498-3052
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
148604
CMS
IL
Enumeration date
09/17/2018
Last updated
03/05/2025
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