Organization
ST, MARY'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA RE (MANAGER OF CREDENTIALING)
(217) 523-5418
Entity
Organization
Contact information
Practice address
409 N 13TH ST, SPRINGFIELD, IL 62702-8422
(217) 816-4189
Mailing address
409 N. 13TH STREET, SPRINGFIELD, IL 62702
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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