Healthcare Provider Details

I. General information

NPI: 1215436449
Provider Name (Legal Business Name): SARAH BUSH LINCOLN HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/02/2018
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COLES CENTRE PKWY
MATTOON IL
61938-9375
US

IV. Provider business mailing address

300 COLES CENTRE PKWY
MATTOON IL
61938-9375
US

V. Phone/Fax

Practice location:
  • Phone: 217-235-0660
  • Fax: 217-235-0306
Mailing address:
  • Phone: 217-235-0660
  • Fax: 217-235-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number203.001988
License Number StateIL

VIII. Authorized Official

Name: SEAN FISCHER
Title or Position: VICE PRESIDENT FINANCE & CFO
Credential:
Phone: 217-258-2591