NPIMap

Organization Active NPI

Iroquois Memorial Hospital

Doing business as Imh Multi Specialty Physician Group

  • General Practice Physician
  • Watseka, IL
National Provider Identifier
1134445851
Registry record updated Apr 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
IROQUOIS MEMORIAL HOSPITAL
Doing business as
Imh Multi Specialty Physician Group
Practice address
200 Laird LN
Watseka, IL 60970-7568
Phone
(815) 432-5841
NPI assigned
Apr 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2010

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

Authorized official

Name
Dennis Wittenborn
Title
Board Chairman
Phone
(815) 432-5841

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

200 Laird LN
Watseka, IL 60970-7568

Mailing address

200 Laird LN
Watseka, IL 60970-7568
Phone (815) 432-5841

Other names 1

  • IMH MULTI SPECIALTY PHYSICIAN GROUP Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Iroquois Memorial Hospi15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271721600000",
    "number": "1134445851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LAIRD LN",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609707568",
            "telephone_number": "815-432-5841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LAIRD LN",
            "city": "WATSEKA",
            "state": "IL",
            "postal_code": "609707568",
            "telephone_number": "815-432-5841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IROQUOIS MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-04-20",
        "status": "A",
        "authorized_official_last_name": "WITTENBORN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "BOARD CHAIRMAN",
        "authorized_official_telephone_number": "815-432-5841"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMH MULTI SPECIALTY PHYSICIAN GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watseka, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.