NPIMap

Organization Active NPI

Harrisburg Medical Center Inc

Doing business as Eldorado Primary Care

  • Rural Health Clinic/Center
  • Eldorado, IL
National Provider Identifier
1073646436
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
0000521 Issued in IL
Legal business name
HARRISBURG MEDICAL CENTER INC
Doing business as
Eldorado Primary Care
Practice address
1007 US Highway 45 N
Eldorado, IL 62930-3767
Phone
(618) 273-7723
Fax
(618) 351-4834
NPI assigned
Mar 14, 2007
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Warren P Ladner
Title
Senior VP Chief Financial Officer
Phone
(618) 457-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 0000521 IL Primary

Addresses

Primary practice location

1007 US Highway 45 N
Eldorado, IL 62930-3767

Mailing address

PO Box 3988
Carbondale, IL 62902-3988
Phone (618) 457-5200

Other names 1

  • Eldorado Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031113000179 IL Part B Supplier - Clinic/Group Practice 9638083884 Receives reassigned benefits from 48 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Eldorado, IL; Harrisburg, IL; Marion, IL
O20100520000473 IL Part A Provider - Rural Health Clinic 9638083884 Practice locations: Eldorado, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1073646436. Details of each certification follow.

Rural health clinic certification: CCN 143473

Legal name
HARRISBURG MEDICAL CENTER INC
Doing business as
ELDORADO PRIMARY CARE
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Oct 1, 2005
Last certification
Dec 17, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Enrollment address
1007 US Highway 45 N
Eldorado, IL 62930-0250
Related CCNs
140210

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).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1239 E Main St
#C
Carbondale, IL 62901

Interoperability endpoints

  • Direct secure messaging: amyquinn@hbmc.allscriptsdirect.net
  • Direct secure messaging: andreamiller@hbmc.allscriptsdirect.net
  • Direct secure messaging: andrewhosman@hbmc.allscriptsdirect.net
  • Direct secure messaging: cayleymeiners@hbmc.allscriptsdirect.net
  • Direct secure messaging: debrakester@hbmc.allscriptsdirect.net
  • Direct secure messaging: gabrielmartin@hbmc.allscriptsdirect.net
  • Direct secure messaging: kaseyharner@hbmc.allscriptsdirect.net
  • Direct secure messaging: katrinatripp@hbmc.allscriptsdirect.net
  • Direct secure messaging: kimballewell@hbmc.allscriptsdirect.net
  • Direct secure messaging: mariegorski@hbmc.allscriptsdirect.net
  • Direct secure messaging: maryozee@hbmc.allscriptsdirect.net
  • Direct secure messaging: naeemqureshi@hbmc.allscriptsdirect.net
  • Direct secure messaging: skylarmccormick@hbmc.allscriptsdirect.net
  • Direct secure messaging: stephaniefranklin@hbmc.allscriptsdirect.net

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
David Businaro Individual Corporate DirectorBoard Member Feb 1, 2018
John Millstead Individual Corporate DirectorBoard Member Aug 1, 2021
Southern Illinois Healthcare Enterprises Inc Organization, Carbondale, IL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Aug 1, 2021 100%
Southern Illinois Hospital Services Organization, Carbondale, IL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 1, 2021 100%
Warren P Ladner Individual Corporate Officer Aug 4, 2023
W-2 Managing Employee Aug 4, 2023
Angela Rowe Individual Corporate DirectorBoard Member Feb 26, 2019
Benna K Daugherty Individual Corporate DirectorBoard Member Apr 23, 2013
Gina Sirach Individual Corporate DirectorBoard Member Jan 1, 2021
Michael Wayne Williams Individual Corporate DirectorBoard Member Feb 28, 2017
Dennis Murphy Individual Corporate DirectorBoard Member Apr 23, 2013
Michael P Tison Individual Corporate DirectorBoard Member Feb 28, 2017
Harrisburg Medical Center Inc Organization, Harrisburg, IL Corporation, Non-profit Operational/Managerial Control Mar 1, 2010 100%
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 11

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

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 14S210 Hospital Operational/Managerial Control Oct 18, 1974
Harrisburg Medical CenterHarrisburg, IL, CCN 14U210 Hospital Operational/Managerial Control Oct 18, 1974
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

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1073646436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3988",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629023988",
            "telephone_number": "618-457-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 US HIGHWAY 45 N",
            "city": "ELDORADO",
            "state": "IL",
            "postal_code": "629303767",
            "telephone_number": "618-273-7723",
            "fax_number": "618-351-4834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARRISBURG MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "LADNER",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "SENIOR VP CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "618-457-5200"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "IL",
            "license": "0000521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eldorado Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eldorado, IL

Sources for this page

Verify at the official NPI Registry.