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General NPI Number Information
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NPI Number | 1891036984
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Entity Type | Organization
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Legal Business Name | JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
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Dates
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Enumeration Date | 03/14/2013
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 15900 SOUTH CICERO AVE
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City | OAK FOREST
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State | IL
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Zip | 60452
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Country | US
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Telephone | 708-687-7200
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Fax | 708-687-4198
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Provider Business Mailing Address
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Address Line | 1900 W POLK ST SUITE 465
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City | CHICAGO
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State | IL
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Zip | 60612-3723
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Country | US
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Telephone | 312-864-5233
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Fax | 312-864-9638
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Authorized Official
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Title or Position | CHAIRMAN
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Name | DR. COURTNEY M.P. HOLLOWELL
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Credential | M.D.
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Telephone | 312-864-5233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036.045279
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License Number State | IL
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