Healthcare Provider Details

I. General information

NPI: 1295990844
Provider Name (Legal Business Name): VHS OF ILLINOIS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3722 HARLEM AVE SUITE LL20
RIVERSIDE IL
60546-2312
US

IV. Provider business mailing address

20 BURTON HILLS BLVD STE 100 ATTENTION: CAROL BAILEY
NASHVILLE TN
37215-6409
US

V. Phone/Fax

Practice location:
  • Phone: 708-783-0602
  • Fax: 708-783-0620
Mailing address:
  • Phone: 615-665-6000
  • Fax: 615-665-6184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
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