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NPI Code Detail

MEDICARE: ST. PAULS CORPORATION

MEDICARE: ST. PAULS CORPORATION
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
1314000000XSkilled Nursing Facility0005165IL

General Provider Information

NPI Number : 1801812284
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST. PAULS CORPORATION
Provider Business Mailing Address
First Line : 3800 N CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3606
Country : US
Telephone Number : 773-478-4222
Fax Number : 773-478-4516
Provider Business Practice Location Address
First Line : 3800 N CALIFORNIA AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60618-3606
Country : US
Telephone Number : 773-478-4222
Fax Number : 773-478-4516
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. ROGER W PAULSBERG
Credential :
Telephone Number : 847-368-7300
Provider Enumeration Date : 07/15/2006
Last Update Date : 12/22/2011

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Directions to “ST. PAULS CORPORATION ” Practice Location

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