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General NPI Number Information
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NPI Number | 1467706184
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Entity Type | Organization
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Legal Business Name | PRESENCE HEALTHCARE
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Dates
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Enumeration Date | 11/02/2012
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Last Update Date | 11/02/2012
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Provider Practice Location Address
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Address Line | 7435 W TALCOTT AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3707
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Country | US
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Telephone | 773-792-5181
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Fax | 773-792-9774
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Provider Business Mailing Address
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Address Line | 7435 W TALCOTT AVE
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City | CHICAGO
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State | IL
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Zip | 60631-3707
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Country | US
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Telephone | 773-792-5181
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Fax | 773-792-9774
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Authorized Official
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Title or Position | PT
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Name | MS. SUSAN SIO
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Credential |
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Telephone | 773-792-5181
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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 | 070.003482
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License Number State | IL
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