Memorial Hospital
Clinic/Center, Rural Health in Chester, IL. Organization (NPI-2).
NPI number1629469002
StatusActive
Last updated in NPPESOct 11, 2024
Details
- NPI
- 1629469002
- Entity type
- Organization (NPI-2)
- Legal business name
- Memorial Hospital
- Organization subpart
- No
- Enumeration date
- Feb 6, 2015
- Certification date
- Oct 11, 2024
- Last updated
- Oct 11, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR1300X | Clinic/Center, Rural Health | – | – | Yes |
| 207Q00000X | Family Medicine | 036-051292 | IL | |
| 207Q00000X | Family Medicine | 036-052369 | IL | |
| 207Q00000X | Family Medicine | 036-130378 | IL | |
| 207Q00000X | Family Medicine | 036-087561 | IL | |
| 208600000X | Surgery | 036-127160 | IL | |
| 208600000X | Surgery | 036-046019 | IL | |
| 282NC0060X | General Acute Care Hospital, Critical Access | 0001495 | IL | |
| 363A00000X | Physician Assistant | 085-003568 | IL | |
| 363A00000X | Physician Assistant | 085-003575 | IL | |
| 363L00000X | Nurse Practitioner | 209-009681 | IL | |
| 367500000X | Nurse Anesthetist, Certified Registered | 041-149926 | IL | |
| 367500000X | Nurse Anesthetist, Certified Registered | 209-009387 | IL |
Other names
- Randolph Hospital District (Other Name)
Practice location
1900 State StChester, IL 62233-1116
Phone 618-826-2388
Mailing address
1900 State StChester, IL 62233-1116
Phone 618-826-4581
Authorized official
Morgan Bendorf
Cfo
6188264581
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