Provider Demographics
NPI:1548472277
Name:HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
Entity type:Organization
Organization Name:HOSPITAL & MEDICAL FOUNDATION OF PARIS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-466-4246
Mailing Address - Street 1:112 W MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:CHRISMAN
Mailing Address - State:IL
Mailing Address - Zip Code:61924-1118
Mailing Address - Country:US
Mailing Address - Phone:217-269-2394
Mailing Address - Fax:217-269-2438
Practice Address - Street 1:112 W MADISON AVE
Practice Address - Street 2:
Practice Address - City:CHRISMAN
Practice Address - State:IL
Practice Address - Zip Code:61924
Practice Address - Country:US
Practice Address - Phone:217-269-2394
Practice Address - Fax:217-269-2438
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2315368OtherBLUE CROSS BLUE SHIELD
IL=========006Medicaid
IL2315368OtherBLUE CROSS BLUE SHIELD