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General NPI Number Information
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NPI Number | 1619918497
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Entity Type | Organization
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Legal Business Name | MERCY HOSPITAL D&T CLINIC
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2525 S MICHIGAN AVE 1ST FLR.
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City | CHICAGO
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State | IL
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Zip | 60616-2333
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Country | US
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Telephone | 312-567-2128
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Fax | 312-328-7702
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Provider Business Mailing Address
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Address Line | 2525 S MICHIGAN AVE 1ST FLR.
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City | CHICAGO
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State | IL
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Zip | 60616-2333
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Country | US
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Telephone | 312-567-2128
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Fax | 312-328-7702
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. PAULA SCHIPIOUR
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Credential |
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Telephone | 312-567-5578
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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 | 001
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License Number State | IL
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