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1891961371 NPI number — ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER

NPI Number: 1891961371
Health Care Provider/Practitioner: ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER

Information about “1891961371” NPI (ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER) exists in 1891961371 in HTML format HTML  |  1891961371 in plain Text format TXT  |  1891961371 in PDF (Portable Document Format) PDF  |  1891961371 in an XML format XML  formats.

NPI Number : 1891961371 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891961371",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ST MARYS HOSPITAL DECATUR OF THE HOSPITAL SISTERS OF THE THIRD ORDER",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3051 HOLLIS DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPRINGFIELD",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "62704-7450",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "217-464-2966",
    "MailingAddressFaxNumber": "217-464-1609",
    "FirstLinePracticeLocationAddress": "1800 E LAKE SHORE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DECATUR",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "62521-3810",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "217-464-2966",
    "PracticeLocationAddressFaxNumber": "217-464-1609",
    "EnumerationDate": "05/05/2008",
    "LastUpdateDate": "10/31/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "EVARD",
    "AuthorizedOfficialFirstName": "MARK",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "VP OF REVENUE CYCLE",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "217-492-9651",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "273Y00000X",
        "TaxonomyName": "Rehabilitation Hospital Unit",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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