Healthcare Provider Details

I. General information

NPI: 1215961818
Provider Name (Legal Business Name): COUNTY OF MERCER HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 02/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 NW 3RD ST
ALEDO IL
61231-1296
US

IV. Provider business mailing address

1007 NW 3RD ST
ALEDO IL
61231-1296
US

V. Phone/Fax

Practice location:
  • Phone: 309-582-3700
  • Fax: 309-582-3737
Mailing address:
  • Phone: 309-582-3700
  • Fax: 309-582-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateIL

VIII. Authorized Official

Name: TED ROGALSKI
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 309-582-3700