Provider Demographics
NPI:1497949903
Name:VHS OF ILL DBA MACNEAL
Entity Type:Organization
Organization Name:VHS OF ILL DBA MACNEAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WINSTON
Authorized Official - Middle Name:DAYALAN
Authorized Official - Last Name:RAJENDRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-783-2000
Mailing Address - Street 1:850 N STATE ST
Mailing Address - Street 2:APT 19H
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60610-8678
Mailing Address - Country:US
Mailing Address - Phone:312-981-1406
Mailing Address - Fax:708-783-3656
Practice Address - Street 1:3231 S EUCLID AVE 5TH FL
Practice Address - Street 2:DEPT OF FAMILY MEDICINE
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402
Practice Address - Country:US
Practice Address - Phone:708-783-2000
Practice Address - Fax:708-783-3656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital