Provident Hospital of Cook County
Organization Active NPI Medicare Defined Swing Bed Hospital Unit · Chicago, IL
NPI 1104842343 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1104842343
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Medicare Defined Swing Bed Hospital Unit 275N00000X
- License
- 03681558 (IL)
- Legal business name
- PROVIDENT HOSPITAL OF COOK COUNTY
- Practice address
- 500 E 51St St
Chicago, IL 60615-2400 - Phone
- (312) 572-2000
- Fax
- (312) 572-2595
- NPI assigned
- Jul 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Mary Abraham, M.D
- Title
- Physician
- Phone
- (312) 572-2000
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medicare Defined Swing Bed Hospital Unit | 275N00000X | 03681558 | IL | Yes |
Addresses
Primary practice location
500 E 51St St
Chicago, IL 60615-2400
Mailing address
7517 Florence Ave
Downers Grove, IL 60516-4482
Phone (630) 271-1270
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- Tim S. Provias
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- Provident Hospital of Cook County
- Provident Hospital of Cook County
- Provider Connection
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All providers in Chicago, IL · Medicare Defined Swing Bed Hospital Unit in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.