Healthcare Provider Details

I. General information

NPI: 1124195557
Provider Name (Legal Business Name): MERCY HARVARD HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
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 P O BOX 850
HARVARD IL
60033-1821
US

V. Phone/Fax

Practice location:
  • Phone: 815-943-2967
  • Fax:
Mailing address:
  • Phone: 815-943-2967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0004911
License Number StateIL

VIII. Authorized Official

Name: SHANNON DUNPHY-ALEXANDER
Title or Position: CFO
Credential:
Phone: 608-757-3126