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NPI Code Detail

MEDICARE: SPARROW SPECIALTY HOSPITAL

MEDICARE: SPARROW SPECIALTY 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
1282N00000XGeneral Acute Care Hospital
2282E00000XLong Term Care Hospital330061MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1508869108
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPARROW SPECIALTY HOSPITAL
Provider Business Mailing Address
First Line : 8175 RELIABLE PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60686-0081
Country : US
Telephone Number : 517-364-4840
Fax Number : 517-364-3215
Provider Business Practice Location Address
First Line : 1215 E MICHIGAN AVE
Second Line :
City : LANSING
State : MI
Zip : 48912-1811
Country : US
Telephone Number : 517-364-4840
Fax Number : 517-364-3218
Authorized Official
Title or Position : SUPERVISOR, PROVIDER ENROLLMENT
Name : MISTY GUNTER RUSSIAN
Credential :
Telephone Number : 517-253-6308
Provider Enumeration Date : 05/27/2005
Last Update Date : 03/11/2024

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1033178553 — YING QIN MD
Practice Location Address:
1215 E MICHIGAN AVE , SPARROW HOSPITAL
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48912-1811
Practice Phone: 517-332-5050
Practice Fax: 517-332-8011

Directions to “SPARROW SPECIALTY HOSPITAL ” Practice Location

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