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General NPI Number Information
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NPI Number | 1568638948
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Entity Type | Organization
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Legal Business Name | EDWARD HINES JR. HOSPITAL
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 05/05/2008
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Provider Practice Location Address
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Address Line | 1085 IDAHO ST
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City | CAROL STREAM
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State | IL
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Zip | 60188-1348
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Country | US
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Telephone | 630-871-9531
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Fax |
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Provider Business Mailing Address
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Address Line | 1085 IDAHO ST
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City | CAROL STREAM
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State | IL
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Zip | 60188-1348
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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 | REGISTERED NURSE
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Name | MS. THRESIAMMA J. PARACKAL
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Credential |
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Telephone | 708-202-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2865M2000X
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Taxonomy Name | Military General Acute Care Hospital
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License Number | 041281069
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License Number State | IL
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