Organization
ABRAHAM LINCOLN MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI C MALTIMORE (MANAGER)
(217) 588-6405
Entity
Organization
Contact information
Practice address
200 STAHLHUT DR, LINCOLN, IL 62656-5066
(217) 732-2161
(217) 735-3526
Mailing address
PO BOX 3428, SPRINGFIELD, IL 62708-3428
(217) 588-2624
(217) 757-7550
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
282N00000X
General Acute Care Hospital
0000018
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F100606037
MEDICARE
IL
Enumeration date
04/17/2007
Last updated
03/10/2021
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