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

St Marys Hospital Decatur of the Hospital Sisters of the Third Order

Organization Urology Physician · NPI 1043486731

St Marys Hospital Decatur of the Hospital Sisters of the Third Order is an Urology Physician in Decatur, Illinois. Registered with an NPI since 2008.

In the registry since
2008

Practice location Address checks out

1770 E Lake Shore Dr Ste 202
Decatur, IL 62521-3832
Phone: (217) 464-2505
Fax: (217) 464-1669
Show map & directions

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

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X

Record details

NPI number1043486731
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Evard — Vp Of Revenue Cycle · (217) 492-9651
Other names Lake Shore Urology At St. Mary'S; Lake Shore Urology At St. Mary'S
NPI enumeratedMay 2, 2008
Last updated in NPPESOctober 31, 2024
Certification dateOctober 31, 2024
Mailing address3051 Hollis Dr, Springfield, IL 62704-7450

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