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NPI Code Detail

MEDICARE: WESTSIDE COMMUNITY HOSPITAL

MEDICARE: WESTSIDE COMMUNITY 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
1207L00000XAnesthesiology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1DA0424OTHERILPALMETTO GBA

General Provider Information

NPI Number : 1073627550
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTSIDE COMMUNITY HOSPITAL
Provider Business Mailing Address
First Line : 3240 W FRANKLIN BLVD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-1511
Country : US
Telephone Number : 773-722-5535
Fax Number :
Provider Business Practice Location Address
First Line : 3240 W FRANKLIN BLVD
Second Line :
City : CHICAGO
State : IL
Zip : 60624-1511
Country : US
Telephone Number : 773-722-5535
Fax Number :
Authorized Official
Title or Position : MANAGER
Name : EDWARD LORGEREE
Credential :
Telephone Number : 773-722-5535
Provider Enumeration Date : 08/19/2006
Last Update Date : 07/25/2008

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Directions to “WESTSIDE COMMUNITY HOSPITAL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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