Organization
KATHERINE SHAW BETHEA HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARRYL VANDERVORT (CEO)
(815) 285-5501
Entity
Organization
Contact information
Practice address
403 E 1ST ST, DIXON, IL 61021-3116
(815) 288-5531
(815) 285-5688
Mailing address
403 E 1ST ST, DIXON, IL 61021-3116
(815) 288-5531
(815) 285-5688
Taxonomy
Speciality
Code
Description
License number
State
275N00000X
Medicare Defined Swing Bed Hospital Unit
Primary
0000497
IL
Other
Enumeration date
07/10/2007
Last updated
08/22/2020
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