Organization
ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK D EVARD (VP OF REVENUE CYCLE)
(217) 492-9651
Entity
Organization
Contact information
Practice address
1750 E LAKE SHORE DR, SUITE LL2, DECATUR, IL 62521-3803
(217) 422-0210
Mailing address
3051 HOLLIS DR, SPRINGFIELD, IL 62704-7450
(217) 464-2966
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
036078656
IL
Other
Enumeration date
08/20/2007
Last updated
10/31/2024
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