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Organization

PEKIN HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY JEPSON (CEO)
(309) 353-0756
Entity
Organization

Contact information

Practice address
600 SO 13TH STREET, PEKIN, IL 61554
(309) 353-0406
(309) 347-1240
Mailing address
600 SO 13TH STREET, PEKIN, IL 61554
(309) 353-0406
(309) 347-1240

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
0001834
IL
367500000X
Certified Registered Nurse Anesthetist
0001834
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0009015677
BLUE CROSS PROFESSIONAL F
IL
Enumeration date
03/21/2007
Last updated
07/06/2012
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