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

St Mary's Hospital, Centralia, Illinois

Organization Emergency Medicine Physician · NPI 1770687196

St Mary's Hospital, Centralia, Illinois is an Emergency Medicine Physician in Centralia, Illinois. Licensed in Illinois. Registered with an NPI since 2006.

Licensed in
IL
In the registry since
2006
Specialties on file
8

Practice location Address checks out

400 N Pleasant Ave
Centralia, IL 62801-3056
Phone: (618) 436-8000
Show map & directions

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

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 0002642 (IL)
Interventional Cardiology Physician Taxonomy 207RI0011X · Licence 0002642 (IL)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 0002642 (IL)
Neurology Physician Taxonomy 2084N0400X · Licence 0002642 (IL)
Radiation Oncology Physician Taxonomy 2085R0001X · Licence 0002642 (IL)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 0002642 (IL)
Certified Respiratory Therapist Taxonomy 227800000X · Licence 0002642 (IL)
Registered Respiratory Therapist Taxonomy 227900000X · Licence 0002642 (IL)

Record details

NPI number1770687196
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Damon Harbison — President · (618) 436-6205
Other names Ssm Health St. Mary'S Hospital - Centralia; Ssm Health St. Mary'S Hospital - Centralia
NPI enumeratedSeptember 8, 2006
Last updated in NPPESNovember 27, 2023
Mailing address1145 Corporate Lake Dr, Saint Louis, MO 63132-2907

Other providers in Centralia