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General NPI Number Information
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NPI Number | 1245501535
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Entity Type | Organization
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Legal Business Name | EVANSTON HOSPTIAL
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 5219 N MASON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-1122
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Country | US
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Telephone | 177-338-6217
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Fax |
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Provider Business Mailing Address
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Address Line | 5219 N MASON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-1122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | UNKOWN
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Name | UNKNOWN UNKNOWN
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Credential |
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Telephone | 123-412-3456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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