Healthcare Provider Details

I. General information

NPI: 1306971080
Provider Name (Legal Business Name): OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E NORRIS DR
OTTAWA IL
61350-1604
US

IV. Provider business mailing address

124 SW ADAMS ST ATTN: STRATEGIC REIMBURSEMENT
PEORIA IL
61602-1308
US

V. Phone/Fax

Practice location:
  • Phone: 815-433-3100
  • Fax:
Mailing address:
  • Phone: 309-655-2850
  • Fax: 309-624-2863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0002071
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBERT C. SEHRING
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 309-655-2850