1629592852 NPI number — ELMHURST COLLEGE

Table of content: MS. CLAIRE VERONICA MCMAHON THOMAS LISW (NPI 1942475769)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629592852 NPI number — ELMHURST COLLEGE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELMHURST COLLEGE
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:
Provider Other Organization Name Type Code:
6
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:
1629592852
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/31/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
190 PROSPECT AVE
Provider Second Line Business Mailing Address:
CIRCLE HALL, ROOM 210
Provider Business Mailing Address City Name:
ELMHURST
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60126-3296
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-617-3555
Provider Business Mailing Address Fax Number:
630-617-6461

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 PROSPECT AVE
Provider Second Line Business Practice Location Address:
CIRCLE HALL, ROOM 210
Provider Business Practice Location Address City Name:
ELMHUST
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60126-3296
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
630-617-3555
Provider Business Practice Location Address Fax Number:
630-617-6461
Provider Enumeration Date:
07/31/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KISSEL
Authorized Official First Name:
KAREN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
630-617-3012

Provider Taxonomy Codes

  • Taxonomy code: 261QH0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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