Provider Demographics
NPI:1336285527
Name:PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK
Entity Type:Organization
Organization Name:PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK
Other - Org Name:PRESENCE MERCY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMITA CFO
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-273-2350
Mailing Address - Street 1:1325 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60506-1449
Mailing Address - Country:US
Mailing Address - Phone:630-892-2222
Mailing Address - Fax:630-801-2506
Practice Address - Street 1:1325 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60506-1449
Practice Address - Country:US
Practice Address - Phone:630-859-2222
Practice Address - Fax:630-801-2506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital