| Organization Name: | GENESIS MEDICAL CENTER, ALEDO |
| NPI Number: | 1053664938 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DOUG CROPPER (CEO) |
| Mailing Address: | 1007 Nw 3rd St Aledo |
| State: | IL US |
| Postal Code: | 612311317 |
| Phone Number: | 3095823701 |
| Fax Number: | 3095823737 |
| NPI Enumeration Date: | 10/17/2012 |
| NPI Last Update Date: | 06/25/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261Q00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |