=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265309405
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CRAWFORD HOSPITAL DISTRICT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/22/2025
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 804 W JOURDAN ST
-----------------------------------------------------
City | NEWTON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62448-1060
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-546-2591
-----------------------------------------------------
Fax | 618-546-2668
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1000 N ALLEN ST
-----------------------------------------------------
City | ROBINSON
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62454-1114
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 618-544-3131
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REVENUE CYCLE DIRECTOR
-----------------------------------------------------
Name | JULIA HOALT
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 618-546-2663
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 213ES0103X
-----------------------------------------------------
Taxonomy Name | Foot & Ankle Surgery Podiatrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------