MEDICARE: IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1215650528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME

Provider Business Mailing Address
First Line	:	200 E FAIRMAN AVE
Second Line	:
City	:	WATSEKA
State	:	IL
Zip	:	60970-1644
Country	:	US
Telephone Number	:	815-432-7775
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 W STATION ST
Second Line	:
City	:	SAINT ANNE
State	:	IL
Zip	:	60964-7251
Country	:	US
Telephone Number	:	815-432-5841
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR MEDICAL STAFF & IT SVCS
Name	:	MICHELLE FOX
Credential	:
Telephone Number	:	815-432-5841

Provider Enumeration Date	:	09/21/2022
Last Update Date	:	05/26/2023

Similar Medicare Providers

1588632681 — SERGEY SHUSHUNOV MD
Practice Location Address:

135 W STATION ST
SAINT ANNE, IL
60964-7251

Practice Phone: 815-427-1324
Practice Fax:

1053577031 — THRESHOLDS SANDLER CENTER
Practice Location Address:

4529 S 8500E RD
SAINT ANNE, IL
60964-4172

Practice Phone: 773-572-5500
Practice Fax:

1487977740 — MRS. KAREN M. WILLIS SLP-P
Practice Location Address:

9887 E 8000S RD
SAINT ANNE, IL
60964-4615

Practice Phone: 815-422-0457
Practice Fax:

1093087645 — 'THERE'S NO PLACE LIKE HOME' MICROBOARD, INC.
Practice Location Address:

2813 S HIELAND RD
SAINT ANNE, IL
60964-5566

Practice Phone: 815-954-5621
Practice Fax:

1134676752 — MORGAN STRATE DPT
Practice Location Address:

5616 S STATE ROUTE 1
SAINT ANNE, IL
60964-5264

Practice Phone: 815-922-5101
Practice Fax:

1841849841 — KELLY JANE NOLAND
Practice Location Address:

6177 E 3500S RD
SAINT ANNE, IL
60964-4049

Practice Phone: 815-422-5013
Practice Fax:

Directions to “IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.