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Hospital Statement of Cost OF Page 1 Illinois Department of Public Aid, Office of Health Finance, 201 S. Grand Ave. E., Springfield, IL 62763 General Information PRELIMINARY Name of Hospital: Jackson
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What is name of hospital?
The name of the hospital is the official name by which the hospital is known.
Who is required to file name of hospital?
The hospital administrators or legal representatives are required to file the name of the hospital.
How to fill out name of hospital?
The name of the hospital can be filled out on the official forms provided by the relevant governing body.
What is the purpose of name of hospital?
The purpose of the name of hospital is to identify the specific hospital and distinguish it from others.
What information must be reported on name of hospital?
The information to be reported on the name of hospital includes the full legal name of the hospital.
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