Provider Demographics
NPI:1467712513
Name:SILVER CROSS HOSPITAL & MEDICAL CENTERS
Entity Type:Organization
Organization Name:SILVER CROSS HOSPITAL & MEDICAL CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KREPPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-300-1100
Mailing Address - Street 1:1980 SILVER CROSS BLVD.,
Mailing Address - Street 2:SUITE 515
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451
Mailing Address - Country:US
Mailing Address - Phone:815-300-3991
Mailing Address - Fax:815-300-3992
Practice Address - Street 1:1980 SILVER CROSS BLVD.
Practice Address - Street 2:SUITE 515
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451
Practice Address - Country:US
Practice Address - Phone:815-300-3991
Practice Address - Fax:815-300-3992
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SILVER CROSS HOSPITAL & MEDICAL CENTERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-05-23
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0005827332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL=========001Medicaid