Healthcare Provider Details
I. General information
NPI: 1124006705
Provider Name (Legal Business Name): VHS OF ILLINOIS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2006
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3249 SOUTH OAK PARK AVE
BERWYN IL
60402-3429
US
IV. Provider business mailing address
20 BURTON HILLS BLVD STE 100 ATTENTION: CAROL BAILEY
NASHVILLE TN
37215-6409
US
V. Phone/Fax
- Phone: 708-783-3222
- Fax: 708-783-3489
- Phone: 615-665-6000
- Fax: 615-665-6184
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RI0200X |
| Taxonomy | Infectious Disease Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZH0000X |
| Taxonomy | Hematology (Pathology) Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRAIG
C.
ARMIN
Title or Position: VP OF GOVT PROGRAMS, TENET
Credential:
Phone: 818-436-2267