Basic Information
| Provider Information | |||||||||
| NPI: | 1316002520 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VALLEY WEST COMMUNITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 904 | ||||||||
| Address2: | |||||||||
| City: | DEKALB | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601150904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157868484 | ||||||||
| FaxNumber: | 8157863705 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 E PLEASANT AVE | ||||||||
| Address2: | |||||||||
| City: | SANDWICH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605481100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157868484 | ||||||||
| FaxNumber: | 8157863705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| AuthorizedOfficialLastName: | ZYDEK | ||||||||
| AuthorizedOfficialFirstName: | CHRISTINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF FINANCE | ||||||||
| AuthorizedOfficialTelephone: | 8157667338 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | IL | N | Hospitals | General Acute Care Hospital | Critical Access | 282NC0060X | IL | Y | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
| ID | Type | State | Issuer | Description | 01923041 | 01 | IL | IL BC 1500 | OTHER | 049299 | 01 | IL | HEALTH ALLIANCE | OTHER |