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Organization

SPARROW IONIA HOSPITAL

Active
Parent organization
SPARROW HEALTH SYSTEM
Other names
University of Michigan Health-Sparrow Ionia Primary Care, SMG Ionia
Organization subpart
Yes

Provider details

NPI number
Legal business name
SPARROW HEALTH SYSTEM
Authorized official
MISTY GUNTER RUSSIAN (SUPERVISOR, PROVIDER ENROLLMENT)
(517) 253-6308
Entity
Organization

Contact information

Practice address
550 E WASHINGTON ST, IONIA, MI 48846-2202
(616) 523-1600
(616) 523-1601
Mailing address
8175 RELIABLE PKWY, CHICAGO, IL 60686-0081
(517) 364-6200
(517) 364-6208

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
207V00000X
Obstetrics & Gynecology Physician
208600000X
Surgery Physician
261QR1300X
Rural Health Clinic/Center
Primary
238550
MI
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16060
BCBS MI
MI
Enumeration date
06/19/2007
Last updated
03/11/2024
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