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General NPI Number Information
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NPI Number | 1417906959
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Entity Type | Organization
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Legal Business Name | HSHS MEDICAL GROUP INC
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 1220 E. TREMONT SUITE A
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City | HILLSBORO
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State | IL
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Zip | 62049-1509
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Country | US
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Telephone | 217-532-9471
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Fax | 217-532-9476
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Provider Business Mailing Address
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Address Line | 1220 E. TREMONT SUITE A
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City | HILLSBORO
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State | IL
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Zip | 62049-1509
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Country | US
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Telephone | 217-532-9471
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Fax | 217-532-9476
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Authorized Official
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Title or Position | CFO
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Name | ANDREW WATSON
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Credential |
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Telephone | 217-492-5806
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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 | 36046053
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License Number State | IL
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