ST. ELIZABETH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF (NPI# 1023097540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023097540 |
| Entity Type | Organization |
| Organization Name | ST. ELIZABETH'S HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER OF |
| Other Organization Name | HSHS ST. ELIZABETH'S HOSPITAL |
| Practice Address |
1 Saint Elizabeth Blvd O Fallon IL 62269-1099 |
| Mailing Address |
211 S 3rd St Belleville IL 62220-1915 |
| Practice Telephone | 6182342120 |
| Practice Fax Number | 6186415486 |
| Mailing Telephone | 6182342120 |
| Mailing Fax Number | 6182224628 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2019-06-12 |
| Authorized Official Name | DAVID NOSACKA (CFO) |
| Authorized Official Telephone | 6186415468 |
| Is Organization Subpart | Y |
| Parent Organization Name | HOSPITAL SISTERS HEALTH SYSTEM |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273Y00000X | Rehabilitation Unit | ========= | IL | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GHP | 4489 | 01 | |
| MS | BLUE CROSS | 0914 | 01 |
| HEALTHLINK | 107847 | 01 | |
| UHC METRAHEALTH | 6701313 | 01 | |
| MO | 010779908 | 05 | |
| IL | BLUE CROSS | 0248 | 01 |
| BLUE CHOICE | 0064066 | 01 |
| Other Name | Type Code |
|---|---|
| HSHS St. Elizabeth's Hospital | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 211 S 3rd St, Belleville, IL 622201915 | 6182342120 | 6182224628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144729716 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Clinic/Center | 180 South Third Street Suite 101, Belleville, IL 62220 | 2018-02-08 |
| 1629057302 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | General Acute Care Hospital | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2006-01-11 |
| 1326268202 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | Internal Medicine | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2007-04-26 |
| Street Address |
1 SAINT ELIZABETH BLVD |
| City | O FALLON |
| State | IL |
| Zip Code | 62269-1099 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629057302 | St. Elizabeth's Hospital of The Hospital Sisters of The Third Order Of | General Acute Care Hospital | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2006-01-11 |
| 1568084903 | Amanda Sue Burgesen | Registered Nurse | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2020-05-07 |
| 1235764218 | Courtney J Harris | Nurse Anesthetist, Certified Registered | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2020-03-10 |
| 1811532666 | Cindy Lynette Sanden | Nurse Practitioner | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-11-14 |
| 1558906750 | Nicole Dawn Brueggemann | Physician Assistant | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-11-12 |
| 1912548587 | Adela Redzic | Physician Assistant | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-10-03 |
| 1578128732 | Carly Rambo | Registered Nurse | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-05-03 |
| 1033670187 | Bart S Bowers | Registered Nurse | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-03-29 |
| 1205300795 | Kris Kahler | Radiology | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2019-01-17 |
| 1033615463 | Shambra Cullum | Nurse Practitioner | 1 Saint Elizabeth Blvd, O Fallon, IL 62269-1099 | 2018-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326648155 | Kayla Revermann | Pharmacist | 1350 W Us Highway 50, Pharmacy, O Fallon, IL 62269 | 2020-10-30 |
| 1942814272 | Ashley Monique Gibson | Behavior Technician | Eagle Center, Ste 10, Ofallon, IL 62269 | 2020-09-03 |
| 1013533819 | Michelle Denise Voudrie | Registered Nurse | 321 Regency Park, O'fallon, IL 62269 | 2020-06-18 |
| 1598398455 | Washington University Physicians In Illinois - Cancer Center Pharmacy | Pharmacy | 1418 Cross Street, Suite 180, Shiloh, IL 62269 | 2020-02-19 |
| 1962063800 | Gerald Paskert | Pharmacist | 122 W. State St., O'fallon, IL 62269 | 2019-06-21 |
| 1780144808 | Bonnie Jean Lampe | Physical Therapy Assistant | 316 Donna Dr, O'fallon, IL 62269 | 2019-03-24 |
| 1134633993 | Latisha Smith | Psychologist | 600 S. Smiley St., O'fallon, IL 62269 | 2017-11-30 |
| 1619407210 | Brenna M Thomas | Registered Nurse | 1310 Engle Ct, O'fallon, IL 62269 | 2017-06-15 |
| 1881135622 | Pc Associates, LLC | Family Medicine | 800 East Highway 50, O'fallon, IL 62269 | 2017-03-13 |
| 1700230539 | Jennifer Farrell | Family Medicine | 3 St. Elizabeth's Blvd, Ste. 4000, O'fallon, IL 62269 | 2016-04-18 |
| Find all providers in zip 62269 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790239895 | Karin Derigne | Rehabilitation Unit | 1101 Highway K, O Fallon, MO 63366-8431 | 2016-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245672658 | Via Physical Therapy, P.C. | Rehabilitation Unit | 4513 Lincoln Ave Ste 212, Lisle, IL 60532-1291 | 2013-07-25 |
| 1659605814 | Elmhurst Rehabilitation Services, P.C. | Rehabilitation Unit | 360 W Butterfield Rd Ste 150, Elmhurst, IL 60126-5099 | 2009-09-21 |
| 1003933797 | Silver Cross Hospital & Medical Centers | Rehabilitation Unit | 1900 Silver Cross Blvd., New Lenox, IL 60451-9508 | 2007-03-26 |
| 1902941628 | Alexian Brothers Medical Center | Rehabilitation Unit | 935 Beisner Rd, Elk Grove Village, IL 60007-3475 | 2007-02-20 |
| 1225122047 | Southern Illinois Hospital Services | Rehabilitation Unit | 201 S. 14th, Herrin, IL 62948 | 2006-10-03 |
| 1780686758 | Merit Lincoln Park LLC | Rehabilitation Unit | 550 W Webster Ave, Chicago, IL 60614-3965 | 2005-08-10 |
| 1316413313 | Pipeline - Weiss Memorial Hospital, LLC | Rehabilitation Unit | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2018-10-17 |
| 1699241612 | Pipeline-westlake Hospital, LLC | Rehabilitation Unit | 1225 W Lake St, Melrose Park, IL 60160-4039 | 2018-10-17 |
| 1134607005 | Advocate North Side Health Network | Rehabilitation Unit | 836 W Wellington Ave, Chicago, IL 60657 | 2018-08-02 |
| 1770096521 | Osf Healthcare System | Rehabilitation Unit | 1400 W Park St, Urbana, IL 61801-2334 | 2017-11-14 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.