Organization Name: | ILLINOIS VALLEY COMMUNITY HOSPITAL |
NPI Number: | 1427421924 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DORINDA BONNELL (DIRECTOR OF PHYSICIAN PRACTICES) |
Mailing Address: | 520 W Walnut St Oglesby |
State: | IL US |
Postal Code: | 613481400 |
Phone Number: | 8158833588 |
Fax Number: | 8158832604 |
NPI Enumeration Date: | 11/05/2015 |
NPI Last Update Date: | 11/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QU0200X |
License Number: | 085005712 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Urgent Care |
Taxonomy Definition: |