MEDICARE: REGIONAL HEALTH PARTNERS LLC

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	363LF0000X	Family Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1801138078
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL HEALTH PARTNERS LLC

Provider Business Mailing Address
First Line	:	1258 W SOUTH ST STE 2
Second Line	:
City	:	KEWANEE
State	:	IL
Zip	:	61443-8300
Country	:	US
Telephone Number	:	309-853-3677
Fax Number	:	309-853-3692

Provider Business Practice Location Address
First Line	:	101 S GALENA AVE
Second Line	:
City	:	WYOMING
State	:	IL
Zip	:	61491-1470
Country	:	US
Telephone Number	:	309-853-3677
Fax Number	:	309-520-2568

Authorized Official
Title or Position	:	DIRECTOR OF BUSINESS OPERATIONS
Name	:	MS. AMANDA C OLDEROG
Credential	:
Telephone Number	:	563-742-2024

Provider Enumeration Date	:	03/26/2013
Last Update Date	:	02/18/2026

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Directions to “REGIONAL HEALTH PARTNERS LLC ” Practice Location

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