Provider Demographics
NPI: | 1306890033 |
---|---|
Name: | SAINT FRANCIS MEDICAL CENTER |
Entity type: | Organization |
Organization Name: | SAINT FRANCIS MEDICAL CENTER |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | C |
Authorized Official - Last Name: | SEHRING |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 309-655-2850 |
Mailing Address - Street 1: | 124 SW ADAMS ST |
Mailing Address - Street 2: | |
Mailing Address - City: | PEORIA |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 61602-1308 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 309-655-2850 |
Mailing Address - Fax: | 309-655-4878 |
Practice Address - Street 1: | 200 E PENNSYLVANIA AVE |
Practice Address - Street 2: | |
Practice Address - City: | PEORIA |
Practice Address - State: | IL |
Practice Address - Zip Code: | 61603-3089 |
Practice Address - Country: | US |
Practice Address - Phone: | 800-589-6070 |
Practice Address - Fax: | 309-683-5969 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | OSF HEALTHCARE SYSTEM |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2006-05-19 |
Last Update Date: | 2024-03-07 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
103T00000X, 207RG0100X, 207R00000X, 207RE0101X, 207RI0200X, 207RR0500X, 208000000X, 2080P0201X, 2084N0400X, 2084P0804X, 363L00000X, 207Q00000X | ||
IL | 036-101573 | 208800000X |
IL | 209-006545 | 364S00000X, 364SM0705X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
No | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | Group - Multi-Specialty | |
No | 2080P0201X | Allopathic & Osteopathic Physicians | Pediatrics | Pediatric Allergy/Immunology | Group - Multi-Specialty |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 2084P0804X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry | Group - Multi-Specialty |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 364S00000X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Group - Multi-Specialty | |
No | 364SM0705X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Medical-Surgical | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
IL | 809840 | Medicare PIN | |
IL | 815950 | Medicare PIN | |
IL | 837650 | Medicare PIN | |
IL | 846900 | Medicare PIN | |
IL | 541550 | Medicare PIN | |
IL | 800880 | Medicare PIN | |
IL | 809870 | Medicare PIN | |
IL | 504850 | Medicare PIN | |
IL | 541390 | Medicare PIN | |
IL | 203444 | Medicare PIN | |
IL | 809860 | Medicare PIN | |
IL | 815980 | Medicare PIN | |
IL | 837640 | Medicare PIN | |
IL | 800830 | Medicare PIN | |
IL | 809810 | Medicare PIN | |
IL | 815990 | Medicare PIN | |
IL | 837660 | Medicare PIN | |
IL | 207594 | Medicare PIN | |
IL | 384150 | Medicare PIN | |
IL | 800860 | Medicare PIN |