Provider Demographics
NPI:1528222635
Name:VHS OF ILLINOIS INC
Entity Type:Organization
Organization Name:VHS OF ILLINOIS INC
Other - Org Name:MACNEAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:SPALDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-6000
Mailing Address - Street 1:20 BURTON HILLS BLVD
Mailing Address - Street 2:SUITE 100 - ATTN: SUSAN VAUGHAN
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-6154
Mailing Address - Country:US
Mailing Address - Phone:615-665-6000
Mailing Address - Fax:615-665-6197
Practice Address - Street 1:3249 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:708-783-3125
Practice Address - Fax:708-783-3166
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VHS OF ILLINOIS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14D0700752291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========401Medicaid