Healthcare Provider Details

I. General information

NPI: 1801975735
Provider Name (Legal Business Name): PRESENCE CHICAGO HOSPITALS NETWORK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 01/01/2022
Certification Date: 01/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N LAKE SHORE DR
CHICAGO IL
60657-5640
US

IV. Provider business mailing address

2900 N LAKE SHORE DR
CHICAGO IL
60657-5640
US

V. Phone/Fax

Practice location:
  • Phone: 773-572-8500
  • Fax: 773-572-8568
Mailing address:
  • Phone: 773-665-3317
  • Fax: 773-665-3460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number0005983
License Number StateIL

VIII. Authorized Official

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