Provider Demographics
NPI:1205105087
Name:SSM HEALTH BUSINESSES
Entity type:Organization
Organization Name:SSM HEALTH BUSINESSES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT PATIENT CARE SERVICE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:SCHWEITZER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:608-778-2146
Mailing Address - Street 1:20 JUNCTION DR W STE 4
Mailing Address - Street 2:
Mailing Address - City:GLEN CARBON
Mailing Address - State:IL
Mailing Address - Zip Code:62034-3060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20 JUNCTION DR W
Practice Address - Street 2:UNIT 4
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-3060
Practice Address - Country:US
Practice Address - Phone:618-288-8020
Practice Address - Fax:618-288-8019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-22
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010902251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========006Medicaid
IL=========007Medicaid
147088Medicare Oscar/Certification