Healthcare Provider Details
I. General information
NPI: 1538206974
Provider Name (Legal Business Name): WEST SUBURBAN HOSPITAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/01/2007
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3 ERIE CT
OAK PARK IL
60302-2519
US
IV. Provider business mailing address
3 ERIE CT
OAK PARK IL
60302-2519
US
V. Phone/Fax
- Phone: 708-763-1010
- Fax: 708-938-4769
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSAN
PFISTER
Title or Position: SYSTEM DIRECTOR, PFS
Credential:
Phone: 773-792-9903