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General NPI Number Information
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NPI Number | 1295787828
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Entity Type | Organization
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Legal Business Name | HSHS HOLY FAMILY HOSPITAL INC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 201 HEALTHCARE DR
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City | GREENVILLE
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State | IL
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Zip | 62246-1155
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Country | US
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Telephone | 618-664-1380
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Fax | 618-664-4239
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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 | 618-664-1380
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Fax | 618-664-4239
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Authorized Official
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Title or Position | VP OF REVENUE CYCLE
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Name | MARK DUANE EVARD
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Credential |
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Telephone | 217-492-9651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 0005355
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License Number State | IL
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