Basic Information
| Provider Information | |||||||||
| NPI: | 1881855773 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAINT JOSEPH HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 425 W SURF ST APT 610 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606576139 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7738653899 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2900 N LAKE SHORE DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7736653000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/23/2008 | ||||||||
| LastUpdateDate: | 06/23/2008 | ||||||||
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| AuthorizedOfficialLastName: | MUHAMMAD | ||||||||
| AuthorizedOfficialFirstName: | SUMMAIYA | ||||||||
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| AuthorizedOfficialTitleorPosition: | RESIDENT PHYSICAIN | ||||||||
| AuthorizedOfficialTelephone: | 7738653899 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 281P00000X | 125052361 | IL | Y | Hospitals | Chronic Disease Hospital |
No ID Information.