Healthcare Provider Details

I. General information

NPI: 1356058119
Provider Name (Legal Business Name): SAINT JAMES HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 KLEEMANN DR
CLINTON IL
61727-2633
US

IV. Provider business mailing address

124 SW ADAMS ST
PEORIA IL
61602-1308
US

V. Phone/Fax

Practice location:
  • Phone: 217-935-5022
  • Fax:
Mailing address:
  • Phone: 309-655-2850
  • Fax: 309-655-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT CARL SEHRING
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 309-655-7869