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General NPI Number Information
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NPI Number | 1801812284
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Entity Type | Organization
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Legal Business Name | ST. PAULS CORPORATION
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 3800 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60618-3606
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Country | US
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Telephone | 773-478-4222
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Fax | 773-478-4516
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Provider Business Mailing Address
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Address Line | 3800 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60618-3606
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Country | US
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Telephone | 773-478-4222
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Fax | 773-478-4516
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ROGER W PAULSBERG
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Credential |
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Telephone | 847-368-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 0005165
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License Number State | IL
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