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General NPI Number Information
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NPI Number | 1235667593
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Entity Type | Organization
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Legal Business Name | GIBSON COMMUNITY HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 05/31/2017
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 201 E 8TH ST
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City | GIBSON CITY
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State | IL
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Zip | 60936-1422
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Country | US
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Telephone | 217-727-1088
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Fax | 217-727-1057
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Provider Business Mailing Address
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Address Line | 1120 N MELVIN ST
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City | GIBSON CITY
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State | IL
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Zip | 60936-1477
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Country | US
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Telephone | 217-727-1088
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Fax | 217-727-1057
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW ERTEL
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Credential |
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Telephone | 217-784-2601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 0000836
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License Number State | IL
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