Provider Demographics
NPI:1922805878
Name:BELOIT HEALTH SYSTEM, INC
Entity type:Organization
Organization Name:BELOIT HEALTH SYSTEM, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, REVENUE CYCLE
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGEBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-364-1615
Mailing Address - Street 1:1701 BLACKHAWK BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BELOIT
Mailing Address - State:IL
Mailing Address - Zip Code:61080
Mailing Address - Country:US
Mailing Address - Phone:815-389-2268
Mailing Address - Fax:815-525-4350
Practice Address - Street 1:1701 BACKHAWK BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH BELOIT
Practice Address - State:IL
Practice Address - Zip Code:61080
Practice Address - Country:US
Practice Address - Phone:815-389-2268
Practice Address - Fax:815-525-4360
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiologyGroup - Multi-Specialty
No291U00000XLaboratoriesClinical Medical Laboratory