Organization
HSHS HOLY FAMILY HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK DUANE EVARD (VP OF REVENUE CYCLE)
(217) 492-9651
Entity
Organization
Contact information
Practice address
200 HEALTH CARE DR, GREENVILLE, IL 62246-1154
(618) 664-0808
(618) 664-9750
Mailing address
3051 HOLLIS DR, SPRINGFIELD, IL 62704-7450
(618) 664-0808
(618) 664-9750
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
0005355
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
310338
BLUECROSS BLUESHIELD
—
01
—
CA3883
MEDICARE RAILROAD
—
Enumeration date
07/24/2006
Last updated
10/31/2024
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