Healthcare Provider Details

I. General information

NPI: 1619202959
Provider Name (Legal Business Name): SAINT JOSEPH HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2009
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N LAKE SHORE DR 2ND FLOOR
CHICAGO IL
60657-5640
US

IV. Provider business mailing address

2900 N LAKE SHORE DR 2ND FLOOR
CHICAGO IL
60657-5640
US

V. Phone/Fax

Practice location:
  • Phone: 773-665-3000
  • Fax:
Mailing address:
  • Phone: 773-665-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN STEINER
Title or Position: DIRECTOR PHYSICIAN SERVICES
Credential:
Phone: 773-665-3000