MEDICARE: THSC LLC

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	282N00000X	General Acute Care Hospital	1820486	IL

General Provider Information

NPI Number	:	1194880310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THSC LLC

Provider Business Mailing Address
First Line	:	4501 N WINCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5265
Country	:	US
Telephone Number	:	773-250-0000
Fax Number	:	773-250-0497

Provider Business Practice Location Address
First Line	:	4501 N WINCHESTER AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5265
Country	:	US
Telephone Number	:	773-250-0000
Fax Number	:	773-250-0497

Authorized Official
Title or Position	:	VP MANAGED CARE
Name	:	DENISE CAMERON
Credential	:
Telephone Number	:	773-250-1119

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	08/24/2007

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Directions to “THSC LLC ” Practice Location

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