Healthcare Provider Details

I. General information

NPI: 1629196688
Provider Name (Legal Business Name): CGH MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 03/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 N GALENA AVE
DIXON IL
61021-1009
US

IV. Provider business mailing address

101 E MILLER RD
STERLING IL
61081-1252
US

V. Phone/Fax

Practice location:
  • Phone: 815-284-1600
  • Fax:
Mailing address:
  • Phone: 815-625-4790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: DR. PAUL STEINKE
Title or Position: PRESIDENT AND CEO
Credential: M.D.
Phone: 815-625-4790