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Contact Information

MISSION CARE OF ILLINOIS, LLC
417 W WOOD ST
DECATUR, IL62522-3109
 Phone: 314-768-1212
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Ambulance

341600000X 59 Ambulance Service Provider
 

Land Transport

3416L0300X 59 Ambulance Service Provider
Indicates primary specialty

NPI Profile & details for MISSION CARE OF ILLINOIS, LLC

NPI Number 1619499878
LBN Legal business name MISSION CARE OF ILLINOIS, LLC
Authorized official BRIAN TIERNEY - (EVP, CHIEF FINANCIAL OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/10/2017
Last updated 05/12/2026 - About a month ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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