1518208289 NPI number — MAJOR HOSPITAL

Table of content: (NPI 1518208289)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518208289 NPI number — MAJOR HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
MAJOR 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:
AUBURN VILLAGE
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:
1518208289
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6840 N LINCOLN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LINCOLNWOOD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60712-2628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-675-7979
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1751 WESLEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AUBURN
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46706-3647
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
260-925-5494
Provider Business Practice Location Address Fax Number:
260-925-6183
Provider Enumeration Date:
03/06/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HORNER
Authorized Official First Name:
JACK
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
317-398-3211

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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