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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