MEDICARE: HENRY FORD HEALTH ST. JOHN HOSPITAL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center
2	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1023088168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HENRY FORD HEALTH ST. JOHN HOSPITAL

Provider Business Mailing Address
First Line	:	3187 SOLUTIONS CTR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-3001
Country	:	US
Telephone Number	:	248-680-8000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3187 SOLUTIONS CTR
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-3001
Country	:	US
Telephone Number	:	248-680-8000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT, VAL BASED ENT & CFO
Name	:	ROBIN DAMSCHRODER
Credential	:
Telephone Number	:	313-876-8452

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	10/09/2025

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