Provider Demographics
NPI:1831107853
Name:ABRAHAM LINCOLN MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:ABRAHAM LINCOLN MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIA PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:CLARENCE
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:QUINT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA
Authorized Official - Phone:217-732-2161
Mailing Address - Street 1:9 FOREST HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:IL
Mailing Address - Zip Code:62656-5314
Mailing Address - Country:US
Mailing Address - Phone:217-737-0345
Mailing Address - Fax:
Practice Address - Street 1:315 8TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:IL
Practice Address - Zip Code:62656-2671
Practice Address - Country:US
Practice Address - Phone:217-732-2161
Practice Address - Fax:217-732-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access