Healthcare Provider Details

I. General information

NPI: 1962642140
Provider Name (Legal Business Name): ST JOSEPHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2009
Last Update Date: 01/21/2026
Certification Date: 01/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12866 TROXLER AVE
HIGHLAND IL
62249-2806
US

IV. Provider business mailing address

3051 HOLLIS DR
SPRINGFIELD IL
62704-7450
US

V. Phone/Fax

Practice location:
  • Phone: 618-651-2600
  • Fax: 618-651-2555
Mailing address:
  • Phone: 618-651-2600
  • Fax: 618-651-2555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ANN BOND
Title or Position: SYSTEM DIRECTOR-GOVERNMENT REIMB
Credential:
Phone: 217-814-4586