MEDICARE: SAINT JOSEPH HOSPITAL-CHICAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	145568/805815	IL

General Provider Information

NPI Number	:	1225025786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAINT JOSEPH HOSPITAL-CHICAGO

Provider Business Mailing Address
First Line	:	2900 N LAKE SHORE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5640
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 N LAKE SHORE DR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5640
Country	:	US
Telephone Number	:	773-665-3317
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. RON STRUXNESS
Credential	:
Telephone Number	:	773-665-3000

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	08/22/2020

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Directions to “SAINT JOSEPH HOSPITAL-CHICAGO ” Practice Location

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