Organization
MCDONOUGH COUNTY HOSPITAL DISTRICT
Active
Other names
McDonough District Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN E DIETZ (PRESIDENT, CEO)
(309) 833-4101
Entity
Organization
Contact information
Practice address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-4101
(309) 836-1525
Mailing address
525 E GRANT ST, MACOMB, IL 61455-3313
(309) 833-4101
(309) 836-1525
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0001438
IL
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
341600000X
Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0325
BLUE CROSS
IL
Enumeration date
05/04/2006
Last updated
06/01/2023
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