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ST MARYS HOSPITAL NPI 1770710360


NPI Information

NPI: 1770710360
Provider Name: ST MARYS HOSPITAL

Doing Business As: ST MARYS UROLOGY

Classification: Urology - 208800000X
Entity Type: Organization
Address:
104 W 6TH ST
STREATOR, IL
ZIP 61364
Phone: (815) 672-7289
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ST MARYS HOSPITAL is an urology in Streator, IL. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. ST MARYS HOSPITAL NPI is 1770710360. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As St Marys Urology.

The provider's business location address is:

104 W 6TH ST
STREATOR, IL
ZIP 61364-899
Phone: (815) 672-7289
Fax: (815) 672-2891

The provider's authorized official is Angie Houch .
The authorized official title is Manager, Pfs and has the following contact phone number (815) 673-4603.

The enumeration date for this NPI number is 6/22/2009 and was last updated on 2/15/2010.


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
1208800000XUrology002659ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11124085758OTHERMD INDIVIDUAL NPI
2IL1789003MEDICARE PINILLINOIS
3IL1789005MEDICARE PINILLINOIS
436113590MEDICAIDILLINOIS
51851349435OTHERMD INDIVIDUAL NPI
636081908MEDICAIDILLINOIS
7IL1789MEDICARE PINILLINOIS
8IL1789002MEDICARE PINILLINOIS
936104105MEDICAIDILLINOIS
101952392557OTHERILLINOISPHYSICIAN NPI

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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