Healthcare Provider Details

I. General information

NPI: 1003869967
Provider Name (Legal Business Name): SAINT ANTHONY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 E GRANT HWY
MARENGO IL
60152-3346
US

IV. Provider business mailing address

124 SW ADAMS ST
PEORIA IL
61602-1308
US

V. Phone/Fax

Practice location:
  • Phone: 800-589-6070
  • Fax: 309-683-5969
Mailing address:
  • Phone: 309-655-2850
  • Fax: 309-655-4878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT C SEHRING
Title or Position: CEO
Credential:
Phone: 309-655-2850