Organization
SOUTHERN ILLINOIS HOSPITAL SERVICES
Active
Other names
St. Joseph Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON S HARTKE (CORPORATE DIRECTOR OF PFS)
(618) 457-5200
Entity
Organization
Contact information
Practice address
2 S HOSPITAL DR, MURPHYSBORO, IL 62966-3333
(618) 684-2156
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
0004614
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141334
MEDICARE PROVIDER NUMBER
IL
01
—
14Z334
MEDICARE SWING BED PROVIDER NUMBER
IL
01
—
613930
MEDICARE PART B PROVIDER NUMBER
IL
Enumeration date
03/10/2014
Last updated
08/18/2026
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