Provider Demographics
NPI:1518075795
Name:FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Entity Type:Organization
Organization Name:FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Other - Org Name:FRANCISCAN HEALTH OLYMPIA FIELDS & CHICAGO HEIGHTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:BANDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-756-1000
Mailing Address - Street 1:1423 CHICAGO RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60411-3400
Mailing Address - Country:US
Mailing Address - Phone:708-756-1000
Mailing Address - Fax:708-756-6863
Practice Address - Street 1:1423 CHICAGO RD
Practice Address - Street 2:
Practice Address - City:CHICAGO HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60411-3400
Practice Address - Country:US
Practice Address - Phone:708-756-1000
Practice Address - Fax:708-756-6863
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANCISCAN ALLIANCE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-28
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0002436273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL31000Medicaid
IL14T172Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER