Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

St Elizabeths Hospital of the Hospital Sisters of the Third Order

Organization Family Medicine Physician · NPI 1104849165

St Elizabeths Hospital of the Hospital Sisters of the Third Order is a Family Medicine Physician in O Fallon, Illinois. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

1512 N Green Mount Rd Ste 108
O Fallon, IL 62269-1953
Phone: (618) 624-5510
Fax: (618) 624-5525
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1104849165
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Evard — Vp Of Revenue Cycle · (217) 492-9651
Other names O'Fallon Family Medicine Center; O'Fallon Family Medicine Center
NPI enumeratedJuly 25, 2006
Last updated in NPPESOctober 31, 2024
Certification dateOctober 31, 2024
Mailing address3051 Hollis Dr, Springfield, IL 62704-7450

Other providers in O Fallon