Provider Demographics
NPI:1851058101
Name:ST MARGARET'S HEALTH - SPRING VALLEY
Entity Type:Organization
Organization Name:ST MARGARET'S HEALTH - SPRING VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATIENT ACCOUNTS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNETTE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KNEEBONE
Authorized Official - Suffix:
Authorized Official - Credentials:DELEGATED OFFICIAL
Authorized Official - Phone:815-664-1477
Mailing Address - Street 1:920 WEST ST STE 116
Mailing Address - Street 2:
Mailing Address - City:PERU
Mailing Address - State:IL
Mailing Address - Zip Code:61354-2765
Mailing Address - Country:US
Mailing Address - Phone:815-223-3300
Mailing Address - Fax:
Practice Address - Street 1:920 WEST ST STE 116
Practice Address - Street 2:
Practice Address - City:PERU
Practice Address - State:IL
Practice Address - Zip Code:61354-2765
Practice Address - Country:US
Practice Address - Phone:815-223-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST MARGARET'S HEALTH - SPRING VALLEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)