Healthcare Provider Details

I. General information

NPI: 1003065863
Provider Name (Legal Business Name): JOHN H STROGER HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2008
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 EAST 51ST STREET
CHICAGO IL
60615
US

IV. Provider business mailing address

500 EAST 51ST STREET
CHICAGO IL
60615
US

V. Phone/Fax

Practice location:
  • Phone: 312-572-2643
  • Fax: 312-572-2669
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: DR. GAIL Y FLOYD
Title or Position: PRAOGRAM DIRECTOR
Credential: M.D.,
Phone: 312-689-0287