Provider Demographics
NPI:1235450388
Name:VHS ACQUISITION SUBSIDIARY NUMBER 4 INC
Entity Type:Organization
Organization Name:VHS ACQUISITION SUBSIDIARY NUMBER 4 INC
Other - Org Name:RIVER FOREST BREAST CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-6000
Mailing Address - Street 1:20 BURTON HILLS BLVD STE 100
Mailing Address - Street 2:ATTENTION: CAROL BAILEY
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6409
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6184
Practice Address - Street 1:420 WILLIAM ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RIVER FOREST
Practice Address - State:IL
Practice Address - Zip Code:60305-1920
Practice Address - Country:US
Practice Address - Phone:708-763-4727
Practice Address - Fax:708-763-2781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL4865Medicare PIN