1477884211 NPI number — ADVOCATE HEALTH AND HOSPITALS CORP.

Table of content: (NPI 1477884211)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477884211 NPI number — ADVOCATE HEALTH AND HOSPITALS CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVOCATE HEALTH AND HOSPITALS CORP.
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:
ADVOCATE BROMENN FAMILY HEALTH CLINIC
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:
1477884211
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2311 W 22ND ST
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
OAK BROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60523-1225
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-320-1090
Provider Business Mailing Address Fax Number:
630-320-1231

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1300 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NORMAL
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
61761-3592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
309-268-3761
Provider Business Practice Location Address Fax Number:
309-268-5620
Provider Enumeration Date:
01/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
VOSS
Authorized Official First Name:
STEPHEN
Authorized Official Middle Name:
R
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
630-320-1090

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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