Provider Demographics
NPI:1811984388
Name:MIDWESTERN REGIONAL MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:MIDWESTERN REGIONAL MEDICAL CENTER, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PIEKARZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-731-4151
Mailing Address - Street 1:2520 ELISHA AVE
Mailing Address - Street 2:
Mailing Address - City:ZION
Mailing Address - State:IL
Mailing Address - Zip Code:60099-2676
Mailing Address - Country:US
Mailing Address - Phone:847-731-4151
Mailing Address - Fax:847-746-4213
Practice Address - Street 1:2501 EMMAUS AVE
Practice Address - Street 2:
Practice Address - City:ZION
Practice Address - State:IL
Practice Address - Zip Code:60099-2587
Practice Address - Country:US
Practice Address - Phone:847-746-4244
Practice Address - Fax:847-746-4213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========Medicaid
IL=========401Medicaid
IL=========401Medicaid