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NPI Code Detail

MEDICARE: THOREK MEMORIAL HOSPITAL

MEDICARE: THOREK MEMORIAL 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
1282N00000XGeneral Acute Care Hospital0005371IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2833730OTHERILMEDICARE GROUP
3809200OTHERILMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10001619077OTHERILBC/BS PHYSICIAN GROUP
4002OTHERILBC/BS

General Provider Information

NPI Number : 1982643961
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOREK MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 850 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60613-3077
Country : US
Telephone Number : 773-525-6780
Fax Number : 773-975-3220
Provider Business Practice Location Address
First Line : 850 W IRVING PARK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60613-3077
Country : US
Telephone Number : 773-525-6780
Fax Number : 773-975-3220
Authorized Official
Title or Position : CEO
Name : EDWARD BUDD
Credential :
Telephone Number : 773-975-6705
Provider Enumeration Date : 06/05/2006
Last Update Date : 03/05/2020

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Directions to “THOREK MEMORIAL HOSPITAL ” Practice Location

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