Healthcare Provider Details

I. General information

NPI: 1649305335
Provider Name (Legal Business Name): COMMUNITY HOSPITAL OF OTTAWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 E NORRIS DR
OTTAWA IL
61350-1604
US

IV. Provider business mailing address

1100 E NORRIS DR
OTTAWA IL
61350-1604
US

V. Phone/Fax

Practice location:
  • Phone: 815-433-3100
  • Fax: 815-431-5520
Mailing address:
  • Phone: 815-433-3100
  • Fax: 815-431-5520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number0002071
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0002071
License Number StateIL

VIII. Authorized Official

Name: MR. ROBERT A CHAFFIN
Title or Position: CEO
Credential:
Phone: 815-431-5456