Healthcare Provider Details

I. General information

NPI: 1679660906
Provider Name (Legal Business Name): PRESENCE CHICAGO HOSPITALS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 01/01/2022
Certification Date: 01/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7435 W TALCOTT AVE
CHICAGO IL
60631-3707
US

IV. Provider business mailing address

100 N RIVER RD
DES PLAINES IL
60016-1209
US

V. Phone/Fax

Practice location:
  • Phone: 773-774-8000
  • Fax:
Mailing address:
  • Phone: 847-813-3666
  • Fax: 847-813-3681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: LISA E NEUMAN
Title or Position: VP FINANCE
Credential:
Phone: 224-273-0516