Provider Demographics
NPI:1497733042
Name:VHS OF ILLINOIS INC
Entity Type:Organization
Organization Name:VHS OF ILLINOIS INC
Other - Org Name:MACNEAL HOSPICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF GOVT PROGRAMS, TENET
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:ARMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-436-2267
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 1:3249 SOUTH OAK PARK AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-3429
Practice Address - Country:US
Practice Address - Phone:708-783-3222
Practice Address - Fax:708-783-3489
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VHS OF ILLINOIS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-04
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2002087251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========002Medicaid
IL141585Medicare Oscar/Certification