Provider Demographics
NPI:1427715853
Name:ST. MARGARET'S HEALTH - SPRING VALLEY
Entity type:Organization
Organization Name:ST. MARGARET'S HEALTH - SPRING VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KNEEBONE
Authorized Official - Suffix:
Authorized Official - Credentials:DELEGATED OFFICIAL
Authorized Official - Phone:815-664-1477
Mailing Address - Street 1:415 E 2ND ST FL 2
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:IL
Mailing Address - Zip Code:61362-1517
Mailing Address - Country:US
Mailing Address - Phone:815-663-2189
Mailing Address - Fax:
Practice Address - Street 1:415 E 2ND ST FL 2
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:IL
Practice Address - Zip Code:61362-1517
Practice Address - Country:US
Practice Address - Phone:815-663-2189
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. MARGARET'S HEALTH - SPRING VALLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)