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Graham Hospital Association

Organization Active NPI Rural Health Clinic/Center · Williamsfield, IL

NPI 1508463563 · NPPES record last updated Apr 3, 2023

Key facts

NPI
1508463563
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
Legal business name
GRAHAM HOSPITAL ASSOCIATION
Practice address
120 E Gale St
Williamsfield, IL 61489-5418
Phone
(309) 639-4004
Fax
(309) 639-4065
NPI assigned
Oct 2, 2020
Organization subpart
No

Authorized official

Name
Janelle M Postin
Title
Credentialing Specialist
Phone
(309) 647-5240

Owners & managing parties with NPI records 4

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

Other NPIs on the same Medicare enrollment 13

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

Other NPIs with the same Medicare PAC ID 14

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

Corporate family (same tax ID) 21

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

Practitioners 127

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

View all 127

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2196077Graham Medical Group
120 E Gale, Williamsfield, IL 61489		Certificate of waiverOct 13, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IL

Rural health clinic certification: CCN 148636

Legal name
GRAHAM HOSPITAL ASSOCIATION
Doing business as
GRAHAM MEDICAL GROUP-WILLIAMSFIELD
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Feb 17, 2023
Last certification
Feb 17, 2023
Ownership / control type
2B
Organization structure
Corporation · Non-profit
Incorporated
Oct 16, 1905 in IL
Enrollment address
120 E Gale St
Williamsfield, IL 61489-5418
Related CCNs
140001

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Allison Sours
Individual 		Corporate Officer
President and Ceo		 Jan 6, 2026
W-2 Managing Employee
President & Ceo		 Jan 5, 2026
Operational/Managerial Control
President & Ceo		 Jan 5, 2026
Morris D Lee
Individual 		Corporate Director
Board Member		 Jan 1, 2022
William Carlberg
Individual 		Corporate Director
Board Member		 Jan 1, 2020
Kenneth Krock
Individual 		Corporate Director
Board Member		 Jan 1, 2021
Terry Moss
Individual 		Corporate Director
Board Member		 Jan 1, 2021
Janis Blout
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Erin Elizabeth Bailey
Individual 		Corporate Director
Board Member		 Jul 1, 2025
Kevin Meade
Individual 		Corporate Director
Board Member		 Jan 1, 2020
Patrick B Renick
Individual 		Corporate Director
Board Member		 Jan 1, 2019
Sarah Keefer
Individual 		Corporate Director
Board Member		 Jul 1, 2025
Julie Reeder
Individual 		Corporate Officer
Cfo		 Mar 6, 2017
W-2 Managing Employee
Cfo		 Mar 6, 2017

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040510000873 IL Part B Supplier - Clinic/Group Practice 2769375021 Receives reassigned benefits from 139 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Galesburg, IL; Williamsfield, IL; Macomb, IL; Lewistown, IL; Glasford, IL; Farmington, IL; Elmwood, IL; Canton, IL
O20220725002615 IL Part a Provider - Rural Health Clinic 2769375021 Practice locations: Williamsfield, IL

National Provider Directory

Tax ID family
Graham Hospital Association (22 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

120 E Gale St
Williamsfield, IL 61489-5418

Mailing address

180 S Main St
Canton, IL 61520-2608
Phone (309) 647-0201

Other names

  • Graham Medical Group Williamsfield Doing business as

Other providers in Williamsfield, IL

All providers in Williamsfield, IL · Rural Health Clinic/Center in Illinois

Sources for this page

Verify at the official NPI Registry.