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General NPI Number Information
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NPI Number | 1518174879
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD HOSPITAL
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 450 WEST HIGHWAY 22
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City | BARRINGTON
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State | IL
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Zip | 60010-7509
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Country | US
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Telephone | 847-381-9600
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Fax |
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Provider Business Mailing Address
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Address Line | 115 HAMPTON ST
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City | CARY
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State | IL
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Zip | 60013-3337
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Country | US
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Telephone | 847-516-3703
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | DEBRA PAWLEY PEARSON
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Credential | PTA
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Telephone | 847-381-9600
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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 | IL
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