1619442266 NPI number — RESILIENCE HEALTHCARE-WEST SUBURBAN MEDICAL CENTER, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619442266 NPI number — RESILIENCE HEALTHCARE-WEST SUBURBAN MEDICAL CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RESILIENCE HEALTHCARE-WEST SUBURBAN MEDICAL CENTER, LLC
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:
WEST SUBURBAN MEDICAL CENTER
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:
1619442266
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WEST SUBURBAN MEDICAL CENTER
Provider Second Line Business Mailing Address:
3 ERIE COURT
Provider Business Mailing Address City Name:
OAK PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60302-2519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-383-6200
Provider Business Mailing Address Fax Number:
708-763-3834

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WEST SUBURBAN MEDICAL CENTER
Provider Second Line Business Practice Location Address:
3 ERIE COURT
Provider Business Practice Location Address City Name:
OAK PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60302-2519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-383-6200
Provider Business Practice Location Address Fax Number:
708-763-3834
Provider Enumeration Date:
10/10/2018

Additional Information

Authorized Official

Authorized Official Last Name:
PRASAD
Authorized Official First Name:
MANOJ
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
708-763-6700

Provider Taxonomy Codes

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

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





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