Healthcare Provider Details

I. General information

NPI: 1992889109
Provider Name (Legal Business Name): SARAH BUSH LINCOLN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W LINCOLN AVE STE 100
CHARLESTON IL
61920-2468
US

IV. Provider business mailing address

1000 HEALTH CENTER DR
MATTOON IL
61938-4644
US

V. Phone/Fax

Practice location:
  • Phone: 800-454-4055
  • Fax: 217-348-6525
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number2002004
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State

VIII. Authorized Official

Name: SEAN FISCHER
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 217-258-2525