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NPI Code Detail

MEDICARE: FREEPORT MEMORIAL HOSPITAL

MEDICARE: FREEPORT MEMORIAL HOSPITAL
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
1282N00000XGeneral Acute Care Hospital059-003025IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000778OTHERILDEPT OF PUBLIC HLTH LIC
2187OTHERILBLUE CROSS

General Provider Information

NPI Number : 1447228788
Entity Type Code : Organization
Provider Name (Legal Business Name) : FREEPORT MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 1045 W STEPHENSON ST
Second Line : PO BOX 857
City : FREEPORT
State : IL
Zip : 61032-4864
Country : US
Telephone Number : 815-599-6000
Fax Number :
Provider Business Practice Location Address
First Line : 1045 W STEPHENSON ST
Second Line :
City : FREEPORT
State : IL
Zip : 61032-4864
Country : US
Telephone Number : 815-599-6000
Fax Number :
Authorized Official
Title or Position : CFO
Name : JOSEPH D MALAS
Credential :
Telephone Number : 815-971-6738
Provider Enumeration Date : 03/11/2006
Last Update Date : 01/15/2026

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Directions to “FREEPORT MEMORIAL HOSPITAL ” Practice Location

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