Healthcare Provider Details
I. General information
NPI: 1437103454
Provider Name (Legal Business Name): GENESIS HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
801 ILLINI DR
SILVIS IL
61282-1804
US
IV. Provider business mailing address
801 ILLINI DR
SILVIS IL
61282-1804
US
V. Phone/Fax
- Phone: 309-792-9363
- Fax: 563-421-3419
- Phone: 309-792-9363
- Fax: 563-421-3419
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282N00000X |
| Taxonomy | General Acute Care Hospital |
| License Number | |
| License Number State | IL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | IL |
VIII. Authorized Official
Name: MR.
CHARLES
E
BRUHN
Title or Position: CEO
Credential:
Phone: 309-792-4265