Healthcare Provider Details

I. General information

NPI: 1902854623
Provider Name (Legal Business Name): CGH MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 08/13/2024
Certification Date: 08/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LE FEVRE RD
STERLING IL
61081-1278
US

IV. Provider business mailing address

100 E LE FEVRE RD
STERLING IL
61081-1278
US

V. Phone/Fax

Practice location:
  • Phone: 815-625-0400
  • Fax: 815-625-2747
Mailing address:
  • Phone: 815-625-0400
  • Fax: 815-625-2747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number0000364
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number0000364
License Number StateIL

VIII. Authorized Official

Name: MS. PAUL A STEINKE
Title or Position: CEO
Credential:
Phone: 815-625-0400