Healthcare Provider Details

I. General information

NPI: 1164484036
Provider Name (Legal Business Name): SWEDISH COVENANT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2006
Last Update Date: 02/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5145 N CALIFORNIA AVE
CHICAGO IL
60625-3661
US

IV. Provider business mailing address

5145 N CALIFORNIA AVE
CHICAGO IL
60625-3661
US

V. Phone/Fax

Practice location:
  • Phone: 773-878-8200
  • Fax: 773-293-4371
Mailing address:
  • Phone: 773-878-8200
  • Fax: 773-293-4371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number002717
License Number StateIL

VIII. Authorized Official

Name: THOMAS GARVEY
Title or Position: SR. VICE PRESIDENT/CFO
Credential:
Phone: 773-878-8200