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 Neurological Surgery Physician · NPI 1639362155

St Marys Hospital Decatur of the Hospital Sisters of the Third Order is a Neurological Surgery Physician in Decatur, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007

Practice location Address checks out

1750 E Lake Shore Dr Ste LL2
Decatur, IL 62521-3803
Phone: (217) 422-0210
Show map & directions

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

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence 036078656 (IL)

Record details

NPI number1639362155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Evard — Vp Of Revenue Cycle · (217) 492-9651
NPI enumeratedAugust 20, 2007
Last updated in NPPESOctober 31, 2024
Certification dateOctober 31, 2024
Mailing address3051 Hollis Dr, Springfield, IL 62704-7450

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