Organization · Type 2 NPI

Gibson Community Hospital Association

Rural Health Clinic/Center · Forrest, IL

NPI number 1063462976 Active

Practice location

122 E Wabash Ave
Forrest, IL 61741-9369

Fax (815) 657-8717

Specialties and licenses

Taxonomy	Code	License
Multi-Specialty Clinic/Center	261QM1300X	None listed
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

6 other providers at this address

NPI record

NPI: 1063462976
Entity type: Organization (Type 2)
Issued: May 11, 2006
Last updated: Feb 4, 2022
Status: Active
Subpart: Yes of Gibson Community Hospital Association

Other names

<unavail>
Prairie Family Medicine and Obstetrics · doing business as
Prairie Family Medicine and Obstetrics · doing business as

Authorized official

Matthew Ertel
Chief Financial Officer
(217) 784-2601

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1063462976

Gibson Community Hospital Association's National Provider Identifier is 1063462976, issued on May 11, 2006. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Forrest, IL. The record was last updated on Feb 4, 2022.