Basic Information
| Provider Information | |||||||||
| NPI: | 1295286045 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MIDWEST MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | GALENA | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610368118 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157771340 | ||||||||
| FaxNumber: | 8157772560 | ||||||||
| Practice Location | |||||||||
| Address1: | 117 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ELIZABETH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 610288800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8158582238 | ||||||||
| FaxNumber: | 8158582239 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2016 | ||||||||
| LastUpdateDate: | 10/17/2016 | ||||||||
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| AuthorizedOfficialLastName: | BAUER | ||||||||
| AuthorizedOfficialFirstName: | TRACY | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT/CEO | ||||||||
| AuthorizedOfficialTelephone: | 8157771340 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.