Healthcare Provider Details
I. General information
NPI: 1912622374
Provider Name (Legal Business Name): SAINT JAMES HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2022
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
106 S 1ST ST
FAIRBURY IL
61739-1509
US
IV. Provider business mailing address
124 SW ADAMS ST
PEORIA IL
61602-1308
US
V. Phone/Fax
- Phone: 815-692-2308
- Fax: 815-692-3278
- Phone: 309-655-2850
- Fax: 815-692-3278
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ROBERT
C
SEHRING
Title or Position: CEO, OSF HEALTHCARE SYSTEM
Credential:
Phone: 309-655-2850