MEDICARE: HOLY CROSS HOSPITAL

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	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1821840828
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOLY CROSS HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 2166
Second Line	:
City	:	BEDFORD PARK
State	:	IL
Zip	:	60499-2166
Country	:	US
Telephone Number	:	773-884-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 W 68TH ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60629-1882
Country	:	US
Telephone Number	:	773-884-9000
Fax Number	:

Authorized Official
Title or Position	:	VP FINANCE
Name	:	DIMAS ORTEGA
Credential	:
Telephone Number	:	737-257-2937

Provider Enumeration Date	:	04/03/2024
Last Update Date	:	04/03/2024

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Directions to “HOLY CROSS HOSPITAL ” Practice Location

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