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GIBSON COMMUNITY HOSPITAL ASSOCIATION NPI 1578086500


NPI Information

NPI: 1578086500
Provider Name: GIBSON COMMUNITY HOSPITAL ASSOCIATION

Doing Business As: GREGORY DELOST, MD

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D0429401

Address:
3 DOCTORS PARK STE A
GIBSON CITY, IL
ZIP 60936
Phone: (217) 784-4030
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GIBSON COMMUNITY HOSPITAL ASSOCIATION is a family medicine in Gibson City, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GIBSON COMMUNITY HOSPITAL ASSOCIATION NPI is 1578086500. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Gregory Delost, Md.

The provider's business location address is:

3 DOCTORS PARK STE A
GIBSON CITY, IL
ZIP 60936-000
Phone: (217) 784-4030
Fax: (217) 784-4405

The provider's authorized official is Matthew Ertel .
The authorized official title is Chief Financial Officer and has the following contact phone number (217) 784-2601.

The CLIA number assigned to this NPI record is 14D0429401 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/21/2017 and was last updated on 3/17/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine0000836ILLINOISYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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