Healthcare Provider Details
I. General information
NPI: 1710604483
Provider Name (Legal Business Name): DEACONESS ILLINOIS UNION COUNTY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2022
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
517 N MAIN ST
ANNA IL
62906-1668
US
IV. Provider business mailing address
PO BOX 631950
CINCINNATI OH
45263-0950
US
V. Phone/Fax
- Phone: 618-833-4511
- Fax: 618-833-8481
- Phone: 812-450-6815
- Fax: 812-450-6822
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 275N00000X |
| Taxonomy | Medicare Defined Swing Bed Hospital Unit |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JASON
ANDREW
HINKLE
Title or Position: CFO
Credential:
Phone: 618-998-7020