| Organization Name: | ST. JOHN'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF ST F |
| NPI Number: | 1093797847 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES L LUCORE (CEO/PRESIDENT) |
| Mailing Address: | 2667 Farragut Dr Springfield |
| State: | IL US |
| Postal Code: | 627048414 |
| Phone Number: | 2175446464 |
| Fax Number: | 2175353989 |
| NPI Enumeration Date: | 11/17/2005 |
| NPI Last Update Date: | 04/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 2000040 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |