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General NPI Number Information
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NPI Number | 1023060613
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Entity Type | Organization
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Legal Business Name | SAINT JAMES HOSPITAL
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 2500 W REYNOLDS ST
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City | PONTIAC
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State | IL
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Zip | 61764-9774
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Country | US
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Telephone | 815-847-2828
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Fax | 815-847-4912
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Provider Business Mailing Address
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Address Line | 124 SW ADAMS ST
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City | PEORIA
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State | IL
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Zip | 61602-1320
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Country | US
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Telephone | 309-655-2850
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Fax |
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Authorized Official
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Title or Position | PRESIDENT, OSF HEALTHCARE SYSTEM
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Name | SISTER DIANE MARIE MCGREW
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Credential |
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Telephone | 309-655-2850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 0005264
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License Number State | IL
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