Organization
IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME
Active
Organization
IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE FOX (DIRECTOR MEDICAL STAFF & IT SVCS)
(815) 432-7775
Entity
Organization
Contact information
Practice address
200 E FAIRMAN AVE, WATSEKA, IL 60970-1644
(815) 432-5841
(815) 432-7821
Mailing address
200 E FAIRMAN AVE, WATSEKA, IL 60970-1644
(815) 432-5841
(815) 432-7821
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
—
—
282NC0060X
Critical Access Hospital
Primary
—
—
282NR1301X
Rural Acute Care Hospital
0001107
IL
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003815082
BLUE SHIELD
IL
01
—
004126
HEALTH ALLIANCE
IL
05
—
100037080A
—
IN
01
—
150
BLUE CROSS
IL
05
—
200262610A
—
IN
05
—
88916
—
IL
05
—
N198101
—
IL
Enumeration date
07/11/2006
Last updated
02/25/2025
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