Organization
MCDONOUGH COUNTY HOSPITAL DISTRICT
Active
Other names
McDonough District Hospital TCU
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN R HOPPER (PRESIDENT CEO)
(309) 833-4101
Entity
Organization
Contact information
Practice address
525 E. GRANT, MACOMB, IL 61455-3313
(309) 833-4101
(309) 836-1525
Mailing address
525 E. GRANT, MACOMB, IL 61455-3313
(309) 833-4101
(309) 836-1525
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
0001438
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146
BLUE CROSS PROVIDER NUMBE
IL
Enumeration date
10/05/2006
Last updated
08/22/2020
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