Organization
ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Active
Parent organization
ST. ELIZABETH'S HOSPITAL
Other names
New Dimensions Reconstructive and Cosmetic Surgery
Organization subpart
Yes
Provider details
NPI number
Legal business name
ST. ELIZABETH'S HOSPITAL
Authorized official
MARK D EVARD (VP OF REVENUE CYCLE)
(217) 492-9651
Entity
Organization
Contact information
Practice address
2900 FRANK SCOTT PKWY W, SUITE 970, BELLEVILLE, IL 62223-5000
(618) 235-8500
(618) 222-4618
Mailing address
3051 HOLLIS DR, SPRINGFIELD, IL 62704-7450
(618) 235-8500
(618) 222-4618
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036118809
IL
Other
Enumeration date
09/10/2007
Last updated
10/31/2024
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