1942354642 NPI number — PRESENCE CHICAGO HOSPITALS NETWORK

Table of content: (NPI 1942354642)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942354642 NPI number — PRESENCE CHICAGO HOSPITALS NETWORK

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRESENCE CHICAGO HOSPITALS NETWORK
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:
PRESENCE SAINTS MARY AND ELIZABETH MEDICAL CENTER-REHABILITATION UNIT
Provider Other Organization Name Type Code:
3
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:
1942354642
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/01/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2233 W DIVISION 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:
60622-3043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
312-770-2000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1127 N OAKLEY BLVD
Provider Second Line Business Practice Location Address:
4TH FLOOR
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60622-3507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-572-8500
Provider Business Practice Location Address Fax Number:
773-572-8568
Provider Enumeration Date:
01/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NEUMAN
Authorized Official First Name:
LISA
Authorized Official Middle Name:
E
Authorized Official Title or Position:
VP FINANCE
Authorized Official Telephone Number:
224-273-0516

Provider Taxonomy Codes

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

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

  • Identifier: 0006 . This is a "BX ILLINOIS PROVIDER NUMB" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: 362171079001 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".




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