MEDICARE: HSHS MEDICAL GROUP INC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1629465414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HSHS MEDICAL GROUP INC

Provider Business Mailing Address
First Line	:	3051 HOLLIS DR FL 2
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62704-7450
Country	:	US
Telephone Number	:	217-492-9695
Fax Number	:

Provider Business Practice Location Address
First Line	:	1745 W WALNUT ST
Second Line	:
City	:	JACKSONVILLE
State	:	IL
Zip	:	62650-6126
Country	:	US
Telephone Number	:	5-326-2798
Fax Number	:	217-243-5003

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	LEANNE M. YANNI
Credential	:	MD
Telephone Number	:	217-492-9648

Provider Enumeration Date	:	04/20/2015
Last Update Date	:	02/18/2026

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