Provider Demographics
NPI:1497401087
Name:PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK
Entity Type:Organization
Organization Name:PRESENCE CENTRAL AND SUBURBAN HOSPITALS NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. DIRECTOR NET REVENUE AND REIMB
Authorized Official - Prefix:
Authorized Official - First Name:MARY JO
Authorized Official - Middle Name:
Authorized Official - Last Name:MACKNISKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-213-0776
Mailing Address - Street 1:77 N AIRLITE STREET
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4912
Mailing Address - Country:US
Mailing Address - Phone:847-695-3200
Mailing Address - Fax:847-931-5742
Practice Address - Street 1:77 N AIRLITE ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4912
Practice Address - Country:US
Practice Address - Phone:847-695-3200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty