MENDOTA COMMUNITY HOSPITAL (NPI# 1407872997) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407872997 |
| Entity Type | Organization |
| Organization Name | MENDOTA COMMUNITY HOSPITAL |
| Other Organization Name | PHYSICIAN SERVICES OF MCH |
| Practice Address |
1401 East 12th Street Mendota IL 61342-9216 |
| Practice Telephone | 8155397461 |
| Practice Fax Number | 8155385516 |
| Mailing Telephone | 8155397461 |
| Mailing Fax Number | 8155391461 |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2012-10-10 |
| Authorized Official Name | MRS. LYNN E KLEIN (CEO) |
| Authorized Official Telephone | 8155397461 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 0001537 | IL | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 0001537 | IL | Allopathic & Osteopathic Physicians |
| N | 363A00000X | Physician Assistant | 0001537 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | 0001537 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 207Q00000X | Family Medicine | 0001537 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | CI2549 | 01 |
| Other Name | Type Code |
|---|---|
| Physician Services of MCH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043872781 | Mendota Community Hospital | Clinic/Center | 1401 E 12th St Ste 400, Mendota, IL 61342-9216 | 2019-07-02 |
| 1609803113 | Mendota Community Hospital | General Acute Care Hospital | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-06-28 |
| 1205383197 | Mendota Community Hospital | Clinic/Center | 1401 Washington Street, Mendota, IL 61342-0001 | 2016-09-08 |
| 1316320849 | Mendota Community Hospital | Clinic/Center | 1405 E 12th St, Mendota, IL 61342-9010 | 2015-07-01 |
| 1376673087 | Mendota Community Hospital | Prosthetic/Orthotic Supplier | 1401 East 12th Street, Mendota, IL 61342-9216 | 2007-03-06 |
| 1962537498 | Mendota Community Hospital | General Acute Care Hospital | 1401 East 12th Street, Mendota, IL 61342-9216 | 2007-02-23 |
| 1417973900 | Mendota Community Hospital | Emergency Medicine | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-15 |
| 1922024843 | Mendota Community Hospital | Medicare Defined Swing Bed Unit | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-14 |
| 1952336323 | Mendota Community Hospital | Nurse Anesthetist, Certified Registered | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-12 |
| 1578598751 | Mendota Community Hospital | Prosthetic/Orthotic Supplier | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-12 |
| Street Address |
1401 EAST 12TH STREET |
| City | MENDOTA |
| State | IL |
| Zip Code | 61342-9216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609803113 | Mendota Community Hospital | General Acute Care Hospital | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-06-28 |
| 1376673087 | Mendota Community Hospital | Prosthetic/Orthotic Supplier | 1401 East 12th Street, Mendota, IL 61342-9216 | 2007-03-06 |
| 1962537498 | Mendota Community Hospital | General Acute Care Hospital | 1401 East 12th Street, Mendota, IL 61342-9216 | 2007-02-23 |
| 1912009887 | James F Meyer | Nurse Anesthetist, Certified Registered | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-09-02 |
| 1114931276 | Kenneth J. Beggs | Nurse Anesthetist, Certified Registered | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-27 |
| 1316960404 | Kenneth K Potts | Nurse Anesthetist, Certified Registered | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-26 |
| 1417973900 | Mendota Community Hospital | Emergency Medicine | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-15 |
| 1922024843 | Mendota Community Hospital | Medicare Defined Swing Bed Unit | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-14 |
| 1952336323 | Mendota Community Hospital | Nurse Anesthetist, Certified Registered | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-12 |
| 1578598751 | Mendota Community Hospital | Prosthetic/Orthotic Supplier | 1401 East 12th Street, Mendota, IL 61342-9216 | 2006-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568536845 | Keri Sundberg | Dentist | 709 Plaza Drive, Mendota, IL 61342 | 2006-11-20 |
| 1114022589 | Goslin Drug Store Inc | Pharmacy | 1212 13th Ave, Mendota, IL 61342 | 2006-09-13 |
| 1467402412 | Neungja Chung | Acupuncturist | Mendota Community Hospital, 1315 Memorial Drive, Mendota, IL 61342 | 2006-05-11 |
| 1487622205 | Kelly R. Minihane | Physician Assistant | 1404 Washington Street, Mendota, IL 61342 | 2006-03-08 |
| 1134193022 | Donald Wilbert Piller | Chiropractor | 1312 Lakewood Dr, Mendota, IL 61342 | 2006-02-15 |
| 1770975377 | National Pain Clinic, LLC | Anesthesiology | 1401 E 12th St, Mendota, IL 61342 | 2015-02-19 |
| 1073869475 | Katherine Rose Riva-foster | Anesthesiology | 1401 E 12th St, Mendota, IL 61342 | 2012-08-03 |
| 1386789220 | Juli Renee Barrett Leifheit | Chiropractor | 901 Main St, Ste A, Mendota, IL 61342 | 2007-02-20 |
| 1205383197 | Mendota Community Hospital | Clinic/Center | 1401 Washington Street, Mendota, IL 61342-0001 | 2016-09-08 |
| 1780699447 | Linnea L Person | Chiropractor | 1301 14th Ave, Mendota, IL 61342-1001 | 2006-07-30 |
| Find all providers in zip 61342 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376643007 | Leonardo Lopez | Family Medicine | 1311 Memorial Dr Ste 500, Mendota, IL 61342-3013 | 2006-09-23 |
| 1750302253 | Mary M Chinn | Family Medicine | 1404 Washington St, Mendota, IL 61342-1471 | 2006-07-21 |
| 1841211380 | David A Scholl | Family Medicine | 1405 East 12th Street, Suite 600, Mendota, IL 61342-9216 | 2006-07-21 |
| 1982676656 | Zachary J Fulton | Family Medicine | 1405 E 12th St Ste 200, Mendota, IL 61342-9011 | 2006-02-06 |
| 1285143354 | Dr. Megan's Healthcare Ministries LLC | Family Medicine | 1201 Meriden St, Mendota, IL 61342-2501 | 2017-09-21 |
| 1184148744 | Joanna Fabris | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2017-07-26 |
| 1376956235 | Mandeep Kaur | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2014-06-09 |
| 1134420144 | Shila Shafii Noori | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2010-11-08 |
| 1588836688 | Kristen Marie Stockamp | Family Medicine | 121 Barboza St, Mendota, CA 93640-1901 | 2008-03-28 |
| 1265562151 | Associated Physicians, Sc | Family Medicine | 1405 E 12th St, Suite 300, Mendota, IL 61342-9011 | 2007-03-07 |
| Find all providers in MENDOTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.