Basic Information
| Provider Information | |||||||||
| NPI: | 1770557951 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHAEL REESE MEDICAL CENTER CORP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2929 S ELLIS AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606163395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127912000 | ||||||||
| FaxNumber: | 3127912252 | ||||||||
| Practice Location | |||||||||
| Address1: | 2929 S ELLIS AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606163395 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3127912000 | ||||||||
| FaxNumber: | 3127912252 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MEADE | ||||||||
| AuthorizedOfficialFirstName: | MARY | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 3127913132 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | 0004986 | IL | Y | Hospital Units | Psychiatric Unit |
No ID Information.