Healthcare Provider Details

I. General information

NPI: 1346207669
Provider Name (Legal Business Name): ROCHELLE COMMUNITY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N 2ND ST
ROCHELLE IL
61068-1764
US

IV. Provider business mailing address

900 N 2ND ST
ROCHELLE IL
61068-1764
US

V. Phone/Fax

Practice location:
  • Phone: 815-562-2181
  • Fax: 815-562-5474
Mailing address:
  • Phone: 815-562-2181
  • Fax: 815-562-5474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number002022
License Number StateIL

VIII. Authorized Official

Name: DORIS M DICKEY
Title or Position: BUSINESS SERVICES MANAGER
Credential:
Phone: 815-562-2181