Healthcare Provider Details

I. General information

NPI: 1427001445
Provider Name (Legal Business Name): MERCY HARVARD HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 GRANT ST
HARVARD IL
60033-1821
US

IV. Provider business mailing address

901 GRANT ST
HARVARD IL
60033-1821
US

V. Phone/Fax

Practice location:
  • Phone: 815-943-5431
  • Fax: 815-943-2726
Mailing address:
  • Phone: 815-943-5431
  • Fax: 815-943-2726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number4911
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number4911
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number0004911
License Number StateIL

VIII. Authorized Official

Name: JOSEPH D MALAS
Title or Position: CFO
Credential:
Phone: 815-971-6738