Healthcare Provider Details

I. General information

NPI: 1790998870
Provider Name (Legal Business Name): HINSDALE HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 02/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 N OAK ST
HINSDALE IL
60521-3829
US

IV. Provider business mailing address

120 N OAK ST
HINSDALE IL
60521-3829
US

V. Phone/Fax

Practice location:
  • Phone: 630-856-5600
  • Fax:
Mailing address:
  • Phone: 630-856-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. RUBY MANN
Title or Position: DIRECTOR MANN
Credential:
Phone: 630-856-6884