MEDICARE: MENDOTA COMMUNITY HOSPITAL

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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1316320849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MENDOTA COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	124 SW ADAMS ST
Second Line	:
City	:	PEORIA
State	:	IL
Zip	:	61602-1320
Country	:	US
Telephone Number	:	309-655-2850
Fax Number	:	815-539-1444

Provider Business Practice Location Address
First Line	:	1405 E 12TH ST
Second Line	:
City	:	MENDOTA
State	:	IL
Zip	:	61342-9010
Country	:	US
Telephone Number	:	815-539-7461
Fax Number	:

Authorized Official
Title or Position	:	CEO, OSF HEALTHCARE SYSTEM
Name	:	ROBERT C. SEHRING
Credential	:
Telephone Number	:	309-655-2850

Provider Enumeration Date	:	07/01/2015
Last Update Date	:	01/08/2025

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Directions to “MENDOTA COMMUNITY HOSPITAL ” Practice Location

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