NPIMap

Organization Active NPI

Harrisburg Medical Center Inc

  • Psychiatric Hospital Unit
  • Harrisburg, IL
National Provider Identifier
1073581872
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
0000521 Issued in IL
Legal business name
HARRISBURG MEDICAL CENTER INC
Practice address
100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Phone
(618) 253-7671
Fax
(618) 252-3763
NPI assigned
Mar 9, 2006
Last updated
Aug 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
HARRISBURG MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shannon S Hartke
Title
Corporate Director PFS
Phone
(618) 457-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 0000521 IL Primary

Addresses

Primary practice location

100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718

Mailing address

1239 E Main St
Carbondale, IL 62901-3175
Phone (618) 457-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100226000566 IL Part A Provider - Hospital 9638083884 Practice locations: Harrisburg, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073581872. Details of each certification follow.

Hospital certification: CCN 14S210

Legal name
HARRISBURG MEDICAL CENTER INC
Doing business as
HARRISBURG MEDICAL CENTER
Organization structure
CorporationNon-profit
Enrollment address
100 Dr Warren Tuttle Dr
Harrisburg, IL 62946-2718
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Harrisburg Medical Ctr6 organizations share this tax ID, including this one
Part of
Harrisburg Medical Ctr

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Krystina L Eubanks Individual Corporate DirectorBoard Member Jun 28, 2025
David Businaro Individual Corporate DirectorBoard Member Feb 1, 2018
John Millstead Individual Corporate DirectorBoard Member Aug 1, 2021
Jacqueline Scott Individual Corporate DirectorBoard Member Mar 28, 2022
Southern Illinois Healthcare Enterprises Inc Organization, Carbondale, IL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2021
Southern Illinois Hospital Services Organization, Carbondale, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021
Warren P Ladner Individual Corporate Officer Aug 4, 2023
W-2 Managing Employee Aug 4, 2023
Angela Rowe Individual Corporate DirectorBoard Member Jan 1, 2020
Gina Sirach Individual Corporate DirectorBoard Member Jan 1, 2021
Matthew C Winkleman Individual Corporate DirectorBoard Member Mar 28, 2022
Harrisburg Medical Center Inc Organization, Harrisburg, IL Corporation, Non-profit Operational/Managerial Control Oct 18, 1974
Shannon S Hartke Individual W-2 Managing Employee Aug 4, 2023
John D Antes Individual Corporate Officer Aug 4, 2023
W-2 Managing Employee Aug 4, 2023

Owners & managing parties with NPI records 13

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 13

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Harrisburg Medical Center IncHarrisburg, IL, CCN 140210 Hospital Operational/Managerial Control (100%) Oct 18, 1974
Harrisburg Medical CenterHarrisburg, IL, CCN 14U210 Hospital Operational/Managerial Control Oct 18, 1974
Eldorado Primary CareEldorado, IL, CCN 143473 Rural health clinic Operational/Managerial Control (100%) Mar 1, 2010
Harrisburg Medical CenterMarion, IL, CCN 148590 Rural health clinic Operational/Managerial Control (100%) Dec 1, 2017

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 16

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787011200000",
    "number": "1073581872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1239 E MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013175",
            "telephone_number": "618-457-5200",
            "fax_number": "618-529-0565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DR WARREN TUTTLE DR",
            "city": "HARRISBURG",
            "state": "IL",
            "postal_code": "629462718",
            "telephone_number": "618-253-7671",
            "fax_number": "618-252-3763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISBURG MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HARRISBURG MEDICAL CENTER INC",
        "enumeration_date": "2006-03-09",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A",
        "authorized_official_last_name": "HARTKE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR PFS",
        "authorized_official_telephone_number": "618-457-5200"
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "IL",
            "license": "0000521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrisburg, IL

Sources for this page

Verify at the official NPI Registry.