NPIMap

Organization Active NPI

HSHS Medical Group Inc

Doing business as HSHS Medical Group Family Medicine

  • Rural Health Clinic/Center
  • Wenona, IL
National Provider Identifier
1316358187
Registry record updated May 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
HSHS MEDICAL GROUP INC
Doing business as
HSHS Medical Group Family Medicine
Practice address
516 S Chestnut St
Wenona, IL 61377-7526
Phone
(815) 853-4402
Fax
(815) 853-4200
NPI assigned
May 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 27, 2014

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

Authorized official

Name
Ms. Melinda Clark
Title
Ceo
Phone
(217) 492-9696

Specialties & licenses 1

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

Addresses

Primary practice location

516 S Chestnut St
Wenona, IL 61377-7526

Mailing address

516 S Chestnut St
Wenona, IL 61377-7526
Phone (815) 853-4402

Other names 1

  • HSHS Medical Group Family Medicine Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1400112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401148800000",
    "number": "1316358187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 S CHESTNUT ST",
            "city": "WENONA",
            "state": "IL",
            "postal_code": "613777526",
            "telephone_number": "815-853-4402",
            "fax_number": "815-853-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S CHESTNUT ST",
            "city": "WENONA",
            "state": "IL",
            "postal_code": "613777526",
            "telephone_number": "815-853-4402",
            "fax_number": "815-853-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HSHS MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-15",
        "last_updated": "2014-05-27",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "217-492-9696",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HSHS Medical Group Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wenona, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2014; 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.