Organization
IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME
Active
Other names
Iroquois Memorial Hospice
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TILSTRA (CEO)
(815) 432-7777
Entity
Organization
Contact information
Practice address
200 E FAIRMAN AVE, WATSEKA, IL 60970-1644
(815) 432-0185
(815) 432-6199
Mailing address
200 E FAIRMAN AVE, WATSEKA, IL 60970-1644
(815) 432-0185
(815) 432-6199
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
2002400
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50344
BCBS PROVIDER #
IL
Enumeration date
06/16/2005
Last updated
11/07/2024
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