Healthcare Provider Details

I. General information

NPI: 1164588679
Provider Name (Legal Business Name): MERCY HEALTH SYSTEM CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MINERAL POINT AVE
JANESVILLE WI
53548-2940
US

IV. Provider business mailing address

1000 MINERAL POINT AVE
JANESVILLE WI
53548-2940
US

V. Phone/Fax

Practice location:
  • Phone: 86-741-3814
  • Fax: 608-741-3816
Mailing address:
  • Phone: 608-756-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number
License Number State

VIII. Authorized Official

Name: JOSEPH D MALAS
Title or Position: CFO
Credential:
Phone: 815-971-6738