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General NPI Number Information
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NPI Number | 1093801797
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Entity Type | Organization
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Legal Business Name | SOUTHERN ILLINOIS HOSPITAL SERVICES
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 405 W JACKSON
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City | CARBONDALE
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State | IL
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Zip | 62901-1000
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Country | US
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Telephone | 618-457-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 1239 E. MAIN PO BOX 3988
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City | CARBONDALE
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State | IL
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Zip | 62901-3988
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Country | US
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Telephone | 618-457-5200
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Fax |
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Authorized Official
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Title or Position | CORPORATE DIRECTOR, PATIENT FINANCI
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Name | SHANNON HARTKE
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Credential | MBA, CHFP
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Telephone | 618-457-5200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 0000513
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License Number State | IL
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