Provider Demographics
NPI:1093973794
Name:ST CATHERINE HOSPITAL
Entity Type:Organization
Organization Name:ST CATHERINE HOSPITAL
Other - Org Name:ST CATHERINE CARE NETWORK
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIRDZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-392-1700
Mailing Address - Street 1:100 WEST CHICAGO AVENUE
Mailing Address - Street 2:SUITE F
Mailing Address - City:EAST CHICAGO
Mailing Address - State:IN
Mailing Address - Zip Code:46312-3260
Mailing Address - Country:US
Mailing Address - Phone:219-397-0193
Mailing Address - Fax:219-397-0657
Practice Address - Street 1:100 WEST CHICAGO AVENUE
Practice Address - Street 2:SUITE F
Practice Address - City:EAST CHICAGO
Practice Address - State:IN
Practice Address - Zip Code:46312-3260
Practice Address - Country:US
Practice Address - Phone:219-397-0193
Practice Address - Fax:219-397-0657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST CATHERINE HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-29
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty