| Organization Name: | JERSEY COMMUNITY HOSPITAL |
| NPI Number: | 1134163827 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JONATHAN WADE (CEO) |
| Mailing Address: | 400 Maple Summit Rd Jerseyville |
| State: | IL US |
| Postal Code: | 620522028 |
| Phone Number: | 6184986402 |
| Fax Number: | 6184988492 |
| NPI Enumeration Date: | 06/15/2006 |
| NPI Last Update Date: | 10/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |