1912093907 NPI number — ST. FRANCIS HOSPITAL TRANSITIONAL CARE UNIT

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912093907 NPI number — ST. FRANCIS HOSPITAL TRANSITIONAL CARE UNIT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ST. FRANCIS HOSPITAL TRANSITIONAL CARE UNIT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912093907
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3051 HOLLIS DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
62704-7450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
217-324-2191
Provider Business Mailing Address Fax Number:
217-324-8715

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1215 FRANCISCAN DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LITCHFIELD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62056-1778
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
217-324-8456
Provider Business Practice Location Address Fax Number:
217-324-8715
Provider Enumeration Date:
10/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
EVARD
Authorized Official First Name:
MARK
Authorized Official Middle Name:
D
Authorized Official Title or Position:
VP OF REVENUE CYCLE
Authorized Official Telephone Number:
217-492-9651

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  0002386 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0929 . This is a "BLUE CROSS" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".




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