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General NPI Number Information
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NPI Number | 1255577540
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Entity Type | Organization
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Legal Business Name | UHS OF HARTGROVE, INC
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 5730 W. ROOSEVELT RD.
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City | CHICAGO
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State | IL
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Zip | 60644-1467
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Country | US
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Telephone | 773-413-1700
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Fax |
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Provider Business Mailing Address
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Address Line | 5730 W. ROOSEVELT RD.
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City | CHICAGO
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State | IL
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Zip | 60644-1467
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Country | US
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Telephone | 773-413-1700
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Fax |
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Authorized Official
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Title or Position | SR VP CFO
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Name | STEVE FILTON
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Credential |
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Telephone | 610-768-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0805X
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Taxonomy Name | Geriatric Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 0005454
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License Number State | IL
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Taxonomy #7
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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