Provider Demographics
NPI:1679108351
Name:HSHS MEDICAL GROUP INC
Entity type:Organization
Organization Name:HSHS MEDICAL GROUP INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HODGKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-492-6594
Mailing Address - Street 1:3 DO IT DR
Mailing Address - Street 2:
Mailing Address - City:ALTAMONT
Mailing Address - State:IL
Mailing Address - Zip Code:62411-1135
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 DO IT DR
Practice Address - Street 2:
Practice Address - City:ALTAMONT
Practice Address - State:IL
Practice Address - Zip Code:62411-1135
Practice Address - Country:US
Practice Address - Phone:618-483-6131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HSHS MEDICAL GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-03
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health