Provider Demographics
NPI: | 1023182177 |
---|---|
Name: | ADVOCATE CHRIST MEDICAL CENTER |
Entity Type: | Organization |
Organization Name: | ADVOCATE CHRIST MEDICAL CENTER |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ATTENDING PHYSICIAN |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | BARBARA |
Authorized Official - Middle Name: | JEAN |
Authorized Official - Last Name: | MCCREARY |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 708-684-8000 |
Mailing Address - Street 1: | 12454 MACKINAC RD |
Mailing Address - Street 2: | |
Mailing Address - City: | HOMER GLEN |
Mailing Address - State: | IL |
Mailing Address - Zip Code: | 60491-8408 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 708-301-6441 |
Mailing Address - Fax: | 708-590-6466 |
Practice Address - Street 1: | 4440 W 95TH ST |
Practice Address - Street 2: | |
Practice Address - City: | OAK LAWN |
Practice Address - State: | IL |
Practice Address - Zip Code: | 60453-2600 |
Practice Address - Country: | US |
Practice Address - Phone: | 708-684-8000 |
Practice Address - Fax: | 708-684-1028 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-11-20 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IL | 00303605724901 | 282N00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 282N00000X | Hospitals | General Acute Care Hospital |