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St. Mary's Hospital
Vascular Surgery Physician in Streator, Illinois
NPI 1598946543

St. Mary's Hospital is a Vascular Surgery Physician based in Streator, IL and is specialized in Vascular Surgery. St. Mary's Hospital practices in Streator, IL. The NPI Number for St. Mary's Hospital is 1598946543 and holds a License No. 036078501 (Illinois).

The current practice location address for St. Mary's Hospital is 104 E Bridge St, Streator, IL and can be reached out via phone at 815-672-4015.

Location: 104 E Bridge St, Streator, IL, 61364-2967
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1598946543
Provider Name
St. Mary's Hospital
Credential
Provider Entity Type
Organization
Address
104 E Bridge St, Streator, IL, 61364-2967
Phone Number
815-672-4015
Fax Number
Provider Enumeration Date
11/19/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
36121627 05 IL
1548281926 01 MD NPI
IL1789 01 IL MEDICARE GROUP
5032121 01 IL BLUESHIELD
institution
Provider Business Practice Location Address Details
Address
104 E Bridge St
City
Streator
State
Illinois
Zip
61364-2967
Phone Number
815-672-4015
Fax Number
person
Provider Business Mailing Address Details
Address
104 E Bridge St
City
Streator
State
Illinois
Zip
61364-2967
Phone Number
815-672-4015
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Vascular Surgery
Taxonomy
2086S0129X
License No.
036078501 (Illinois)
Definition
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
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