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NPI 1225035074

NPI 1225035074 : ST MARYS HOSPITAL STREATOR HOSPITAL SISTERS OF THE 3RD ORDR ST FRANCIS : STREATOR, IL

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General NPI Number Information
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    NPI Number           |    1225035074
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    Entity Type          |    Organization 
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    Legal Business Name  |    ST MARYS HOSPITAL STREATOR HOSPITAL SISTERS OF THE 3RD ORDR ST FRANCIS 
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Dates
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    Enumeration Date     |    07/07/2005
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    Last Update Date     |    03/20/2013
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Provider Practice Location Address
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    Address Line         |    111 SPRING ST 
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    City                 |    STREATOR
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    State                |    IL
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    Zip                  |    61364-3332
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    Country              |    US
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    Telephone            |    815-673-4513
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    Fax                  |    815-673-4593
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Provider Business Mailing Address
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    Address Line         |    111 SPRING ST 
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    City                 |    STREATOR
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    State                |    IL
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    Zip                  |    61364-3332
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    Country              |    US
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    Telephone            |    815-673-4513
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    Fax                  |    815-673-4593
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Authorized Official
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    Title or Position    |    EXECUTIVE VICE PRESIDENT
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    Name                 |     JOANNE  FENTON 
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    Credential           |    
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    Telephone            |    815-673-2311
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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       |    
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    License Number State |    
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