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General NPI Number Information
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NPI Number | 1588739734
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Entity Type | Organization
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Legal Business Name | SWEDISH COVENANT HEALTH
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 02/21/2024
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Provider Practice Location Address
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Address Line | 5140 N CALIFORNIA AVE G-105
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City | CHICAGO
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State | IL
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Zip | 60625-3645
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Country | US
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Telephone | 773-989-3980
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Fax | 773-989-6285
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Provider Business Mailing Address
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Address Line | 5140 N CALIFORNIA AVE G-105
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City | CHICAGO
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State | IL
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Zip | 60625-3645
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Country | US
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Telephone | 773-989-3980
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Fax | 773-989-6285
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Authorized Official
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Title or Position | AVP ASST CONTROLLER
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Name | ELLEN DANIEL
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Credential |
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Telephone | 847-570-5103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 054015358
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License Number State | IL
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