Provider Demographics
NPI:1558419523
Name:OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER
Entity Type:Organization
Organization Name:OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER
Other - Org Name:OTTAWA REGIONAL HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:SEHRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-655-2850
Mailing Address - Street 1:124 SW ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61602-1308
Mailing Address - Country:US
Mailing Address - Phone:309-655-2850
Mailing Address - Fax:309-655-4878
Practice Address - Street 1:1601 MERCURY CIRCLE
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-9333
Practice Address - Country:US
Practice Address - Phone:815-433-6090
Practice Address - Fax:815-431-5582
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1002997251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1002997OtherIL DEPT OF PUBLIC HEALTH
9661OtherBLUE CROSS BLUE SHIELD IL
9661OtherBLUE CROSS BLUE SHIELD IL
IL=========002Medicaid