| Organization Name: | IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME |
| NPI Number: | 1285718478 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHARLES BOHLMANN (CEO) |
| Mailing Address: | 200 E Fairman Ave Watseka |
| State: | IL US |
| Postal Code: | 609701644 |
| Phone Number: | 8154325841 |
| Fax Number: | 8154327821 |
| NPI Enumeration Date: | 10/24/2006 |
| NPI Last Update Date: | 05/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 275N00000X |
| License Number: | 0001107 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Hospital Units |
| Taxonomy Classification: | Medicare Defined Swing Bed Unit |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A unit of a hospital that has a Medicare provider agreement and has been granted approval from HCFA to provide post-hospital extended care services and be reimbursed as a swing-bed unit. |