Healthcare Provider Details

I. General information

NPI: 1689200578
Provider Name (Legal Business Name): ST. LUKE'S HOSPITAL OF DULUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 E 1ST ST
DULUTH MN
55805-2107
US

IV. Provider business mailing address

29980 NETWORK PL
CHICAGO IL
60673-1299
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-5439
  • Fax: 218-249-5624
Mailing address:
  • Phone: 715-847-2304
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: JERRY YANG
Title or Position: SVP - CHIEF FINANCIAL OFFICER
Credential:
Phone: 715-847-2526