Online Patient Payment Center
Welcome to the Online Payment Center. You may pay your hospital bills here by credit/debit card.
Information entered here is for Iroquois Memorial Hospital and Satellite Clinics only. Bills pertaining to Physicians with privileges to practice at IMH, including hospital-based physicians such as emergency physicians, pathologists, radiologists and anesthesiologists are not employees or agents of IMH and you will receive a separate bill for their services.
For your convenience please fill out the payment form below. All information will be kept secure and confidential. For more information you may call our business office between 8:00 a.m. and 4:00 p.m. at 815-432-7706.
You may make payments to the Hospital submitting your credit card information in below fields.
All payments are via secure server. Thank you for allowing us to serve you.
Name Of Patient
Name of Patient Treated. Please use first name, followed by last name.
Patient Account Number
Account Number. (Should Be Located On Your Bill)
Name associated with billing address. Please use first name, followed by last name.
In case we need to contact you
Comments Or Messages Related To Your Payment
Cardholder First Name
The first name of the account holder as it appears on the credit card.
Cardholder Last Name
The last name of the account holder as it appears on the credit card.
Amount of Payment
Format: 45.67 (Include decimal and cents. Do not use a dollar sign.)
Card Code Verification Number
The three digit number on the back of your card. (Four digit code on the front of American Express.)
Billing Postal or Street Address
District Of Columbia
Billing Zip Code
5 digit zip code