Healthcare Provider Details

I. General information

NPI: 1205674611
Provider Name (Legal Business Name): HOLY FAMILY MEDICAL CENTER - DES PLAINES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2024
Last Update Date: 07/18/2024
Certification Date: 07/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N RIVER RD
DES PLAINES IL
60016-1209
US

IV. Provider business mailing address

100 N RIVER RD
DES PLAINES IL
60016-1209
US

V. Phone/Fax

Practice location:
  • Phone: 847-297-1800
  • Fax:
Mailing address:
  • Phone: 847-297-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DOAN
Title or Position: MANAGING ASSOCIATE GENERAL COUNSEL
Credential:
Phone: 310-259-4706