Basic Information
| Provider Information | |||||||||
| NPI: | 1235755372 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MCDONOUGH COUNTY HOSPITAL DISTRICT | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1179 | ||||||||
| Address2: | |||||||||
| City: | MACOMB | ||||||||
| State: | IL | ||||||||
| PostalCode: | 614555579 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3098361524 | ||||||||
| FaxNumber: | 3098361525 | ||||||||
| Practice Location | |||||||||
| Address1: | 515 E GRANT ST STE 213 | ||||||||
| Address2: | |||||||||
| City: | MACOMB | ||||||||
| State: | IL | ||||||||
| PostalCode: | 614553378 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3098376937 | ||||||||
| FaxNumber: | 3098371979 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2020 | ||||||||
| LastUpdateDate: | 06/24/2020 | ||||||||
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| AuthorizedOfficialLastName: | MURDOCK | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5632443511 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 06/24/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.