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NPI Code Detail

MEDICARE: ST MARYS HOSPITAL STREATOR HOSPITAL SISTERS OF THE 3RD ORDR ST FRANCIS

MEDICARE: ST MARYS HOSPITAL STREATOR HOSPITAL SISTERS OF THE 3RD ORDR ST FRANCIS
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
1251E00000XHome Health Agency1001791IL

General Provider Information

NPI Number : 1336146729
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST MARYS HOSPITAL STREATOR HOSPITAL SISTERS OF THE 3RD ORDR ST FRANCIS
Provider Business Mailing Address
First Line : 111 SPRING ST
Second Line :
City : STREATOR
State : IL
Zip : 61364-3332
Country : US
Telephone Number : 815-673-4516
Fax Number : 815-673-4542
Provider Business Practice Location Address
First Line : 111 SPRING ST
Second Line :
City : STREATOR
State : IL
Zip : 61364-3332
Country : US
Telephone Number : 815-673-4516
Fax Number : 815-673-4542
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : MARK S O'HALLA
Credential :
Telephone Number : 815-673-2311
Provider Enumeration Date : 06/30/2005
Last Update Date : 10/11/2012

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Directions to “ST MARYS HOSPITAL STREATOR HOSPITAL SISTERS OF THE 3RD ORDR ST FRANCIS ” 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.

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