Healthcare Provider Details

I. General information

NPI: 1316320849
Provider Name (Legal Business Name): MENDOTA COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2015
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1405 E 12TH ST
MENDOTA IL
61342-9010
US

IV. Provider business mailing address

124 SW ADAMS ST
PEORIA IL
61602-1320
US

V. Phone/Fax

Practice location:
  • Phone: 815-539-7461
  • Fax:
Mailing address:
  • Phone: 309-655-2850
  • Fax: 815-539-1444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT C. SEHRING
Title or Position: CEO, OSF HEALTHCARE SYSTEM
Credential:
Phone: 309-655-2850