Healthcare Provider Details
I. General information
NPI: 1700107380
Provider Name (Legal Business Name): VHS WEST SUBURBAN MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2010
Last Update Date: 03/15/2021
Certification Date: 03/15/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 ERIE CT
OAK PARK IL
60302-2519
US
IV. Provider business mailing address
20 BURTON HILLS BLVD ATTN: CAROL BAILEY
NASHVILLE TN
37215-6197
US
V. Phone/Fax
- Phone: 708-383-6200
- Fax:
- Phone: 615-665-6000
- Fax: 615-665-6184
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRAIG
C.
ARMIN
Title or Position: VP OF GOVT PROGRAMS, TENET
Credential:
Phone: 818-436-2267