Organization
MENDOTA COMMUNITY HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT C. SEHRING (CEO OSF HEALTHCARE SYSTEM)
(309) 655-2850
Entity
Organization
Contact information
Practice address
909 MAIN ST, MENDOTA, IL 61342-1654
(815) 539-1421
(815) 539-5507
Mailing address
124 SW ADAMS ST, PEORIA, IL 61602-1308
(309) 655-2850
(309) 655-4878
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1007491
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9980
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/28/2005
Last updated
03/18/2024
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