Healthcare Provider Details
I. General information
NPI: 1770533119
Provider Name (Legal Business Name): SAINT FRANCIS MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
530 NE GLEN OAK AVE
PEORIA IL
61637-0001
US
IV. Provider business mailing address
124 SW ADAMS ST
PEORIA IL
61602-1308
US
V. Phone/Fax
- Phone: 309-655-2000
- Fax: 309-655-7869
- Phone: 309-655-2850
- Fax: 309-655-4878
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416A0800X |
| Taxonomy | Air Ambulance |
| License Number | 22524 |
| License Number State | IL |
VIII. Authorized Official
Name:
ROBERT
C
SEHRING
Title or Position: CEO
Credential:
Phone: 309-655-2850