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IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME NPI 1790889194


NPI Information

NPI: 1790889194
Provider Name: IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME

Doing Business As: IMH MULTI-SPECIALTY PHYSICIANS

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
200 LAIRD LN
WATSEKA, IL
ZIP 60970
Phone: (815) 432-5411
Get Directions

IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME is a clinic center in Watseka, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). IROQUOIS MEMORIAL HOSPITAL AND RESIDENT HOME NPI is 1790889194. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Imh Multi-specialty Physicians.

The provider's business location address is:

200 LAIRD LN
WATSEKA, IL
ZIP 60970-568
Phone: (815) 432-5411
Fax: (815) 432-3955

The provider's authorized official is Chuck Bohlmann .
The authorized official title is President/ceo and has the following contact phone number (815) 432-7736.

The enumeration date for this NPI number is 9/7/2006 and was last updated on 9/19/2014.


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 MedicineNo
2207V00000XObstetrics & GynecologyNo
3208000000XPediatricsNo
4208600000XSurgeryNo
5261Q00000XClinic/CenterYes

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
1214521MEDICARE PINILLINOIS

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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