Healthcare Provider Details

I. General information

NPI: 1659868206
Provider Name (Legal Business Name): MACKINAC STRAITS HEALTH SYSTEM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 S HURON ST
CHEBOYGAN MI
49721-2267
US

IV. Provider business mailing address

1140 N STATE ST
SAINT IGNACE MI
49781-1048
US

V. Phone/Fax

Practice location:
  • Phone: 231-597-8192
  • Fax: 231-597-8463
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SONJA SPRAGUE
Title or Position: CREDENTIALING
Credential:
Phone: 906-643-0451