Healthcare Provider Details

I. General information

NPI: 1679108351
Provider Name (Legal Business Name): HSHS MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2020
Last Update Date: 04/27/2023
Certification Date: 04/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 DO IT DR
ALTAMONT IL
62411-1135
US

IV. Provider business mailing address

3 DO IT DR
ALTAMONT IL
62411-1135
US

V. Phone/Fax

Practice location:
  • Phone: 618-483-6131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY HODGKINSON
Title or Position: CFO
Credential:
Phone: 217-492-6594