Ingalls Memorial Hospital

Primary specialty

Rehabilitation HospitalTaxonomy code 283X00000X

License

146002609 Issued in IL

Legal business name

INGALLS MEMORIAL HOSPITAL

Practice address

15620 Wood St
Harvey, IL 60426-4171

Phone

(708) 915-4229

NPI assigned

Dec 14, 2012

Last updated

Dec 14, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Curt Johnson

Title

Ceo

Phone

(708) 333-2300

Specialties & licenses 6

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1801132105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15620 WOOD ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15620 WOOD ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604264171",
            "telephone_number": "708-915-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INGALLS MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CURT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-333-2300"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "146002609",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "IL",
            "license": "146002609",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IL",
            "license": "146002609",
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "IL",
            "license": "146002609",
            "primary": true
        },
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "IL",
            "license": "146002609",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IL",
            "license": "146002609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362170866001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "362170866002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingalls Memorial Hospital
• Ingalls Memorial Hospital
• Ingalls Memorial Hospital
• Ingalls Memorial Hospital
• Ingalls Memorial Hospital
• Ingalls Memorial Hospital
• Ingalls Professional Pharmacy 4
• Craig Irvine, DMD
• David Philip Ison, M.D.
• Jarmo J Itkonen, MD

• Rehabilitation Hospital in Harvey, IL
• Providers in Harvey, IL by specialty
• Rehabilitation Hospital in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.