1194723999 NPI number — SAINT ANTHONY HOSPITAL

Table of content: (NPI 1194723999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194723999 NPI number — SAINT ANTHONY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAINT ANTHONY HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CATHOLIC HEALTH PARTNERS SERVICES
Provider Other Organization Name Type Code:
4
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194723999
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2875 W 19TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60623-3501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-484-1000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2875 W 19TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60623-3501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-484-4800
Provider Business Practice Location Address Fax Number:
773-484-4806
Provider Enumeration Date:
07/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MEDAGLIA
Authorized Official First Name:
GUY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT/CEO, AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
773-484-1000

Provider Taxonomy Codes

  • Taxonomy code: 273Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 282N00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282NC0060X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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