| St. Mary Hospital Preferred Professionals | |
|
1800 E Lake Shore Dr Suite T303 Decatur IL 62521-3810 | |
| (217) 464-2505 | |
| (217) 464-1669 |
| Full Name | St. Mary Hospital Preferred Professionals |
|---|---|
| Speciality | Family Medicine |
| Location | 1800 E Lake Shore Dr, Decatur, Illinois |
| Authorized Official Name and Position | Mark D Evard (VP OF REVENUE CYCLE) |
| Authorized Official Contact | 2174929651 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Mary Hospital Preferred Professionals 3051 Hollis Dr Springfield IL 62704-7450 Ph: (217) 464-2505 | St. Mary Hospital Preferred Professionals 1800 E Lake Shore Dr Suite T303 Decatur IL 62521-3810 Ph: (217) 464-2505 |
| NPI Number | 1215108139 |
|---|---|
| Provider Enumeration Date | 03/19/2008 |
| Last Update Date | 10/31/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215108139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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