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General NPI Number Information
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NPI Number | 1316705528
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Entity Type | Organization
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Legal Business Name | THOREK MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 03/12/2024
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Last Update Date | 03/12/2024
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Provider Practice Location Address
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Address Line | 4950 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60640-3477
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Country | US
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Telephone | 773-989-1501
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Fax |
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Provider Business Mailing Address
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Address Line | 4950 N ASHLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60640-3477
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Country | US
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Telephone | 773-989-1501
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | TIM HEINRICH
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Credential |
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Telephone | 773-975-6806
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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