| Organization Name: | KATHERINE SHAW BETHEA HOSPITAL |
| NPI Number: | 1205031721 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID SCHREINER (COO) |
| Mailing Address: | 101 W 2nd St Suite 203 Dixon |
| State: | IL US |
| Postal Code: | 610213076 |
| Phone Number: | 8152845710 |
| Fax Number: | 8152855893 |
| NPI Enumeration Date: | 06/15/2007 |
| NPI Last Update Date: | 08/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | 2001576 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |