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NPI Code Detail

MEDICARE: COMMUNITY MEDICAL CENTER OF WESTERN IL INC

MEDICARE: COMMUNITY MEDICAL CENTER OF WESTERN IL INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency1010048IL

General Provider Information

NPI Number : 1265432363
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITY MEDICAL CENTER OF WESTERN IL INC
Provider Business Mailing Address
First Line : 1000 W HARLEM AVE
Second Line :
City : MONMOUTH
State : IL
Zip : 61462-1007
Country : US
Telephone Number : 309-734-3141
Fax Number : 309-734-3029
Provider Business Practice Location Address
First Line : 1000 W HARLEM AVE
Second Line :
City : MONMOUTH
State : IL
Zip : 61462-1007
Country : US
Telephone Number : 309-734-3141
Fax Number : 309-734-3029
Authorized Official
Title or Position : PROJECTS COORDINATOR
Name : MR. BRETT L STAHL
Credential :
Telephone Number : 309-734-1431
Provider Enumeration Date : 07/29/2005
Last Update Date : 08/22/2020

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1881680478 — MR. KEVIN J KUSLER PA-C
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1477549046 — JOHN K KNAPEK
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1063408631 — DR. VICTORIA KALIVODA -POPELA DO
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Directions to “COMMUNITY MEDICAL CENTER OF WESTERN IL INC ” Practice Location

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