Healthcare Provider Details

I. General information

NPI: 1629295324
Provider Name (Legal Business Name): HOOPESTON COMMUNITY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 05/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 N. CHICAGO STREET
ROSSVILLE IL
60963-0248
US

IV. Provider business mailing address

701 E ORANGE ST
HOOPESTON IL
60942-1801
US

V. Phone/Fax

Practice location:
  • Phone: 217-748-4141
  • Fax: 217-748-6973
Mailing address:
  • Phone: 217-383-6792
  • Fax: 217-383-4752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number000420
License Number StateIL

VIII. Authorized Official

Name: HARRY F. BROCKUS
Title or Position: CEO
Credential:
Phone: 217-283-8540