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General NPI Number Information
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NPI Number | 1225548753
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Entity Type | Organization
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Legal Business Name | ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER
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Dates
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Enumeration Date | 10/11/2017
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 791 WALL ST STE 200
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City | O FALLON
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State | IL
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Zip | 62269-2087
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Country | US
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Telephone | 866-650-4660
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Fax | 618-222-4660
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Provider Business Mailing Address
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Address Line | 3051 HOLLIS DR
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City | SPRINGFIELD
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State | IL
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Zip | 62704-7450
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Country | US
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Telephone | 888-650-7474
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Fax | 618-222-4660
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Authorized Official
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Title or Position | SYSTEM DIRECTOR-GOVERNMENT REIMB
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Name | ANN BOND
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Credential |
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Telephone | 217-814-4586
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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