Provider Demographics
NPI:1578805743
Name:REGIONAL HEALTH PARTNERS LLC
Entity Type:Organization
Organization Name:REGIONAL HEALTH PARTNERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OD BUSINESS OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:OLDEROG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-742-2024
Mailing Address - Street 1:1258 W SOUTH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:KEWANEE
Mailing Address - State:IL
Mailing Address - Zip Code:61443-8300
Mailing Address - Country:US
Mailing Address - Phone:309-853-3677
Mailing Address - Fax:309-853-3692
Practice Address - Street 1:336 FRONT ST
Practice Address - Street 2:
Practice Address - City:GALVA
Practice Address - State:IL
Practice Address - Zip Code:61434-1365
Practice Address - Country:US
Practice Address - Phone:309-932-3101
Practice Address - Fax:309-932-3154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty