Provider Demographics
NPI:1578741526
Name:SWEDISH COVENANT MANAGED CARE ALLIANCE, INC.
Entity Type:Organization
Organization Name:SWEDISH COVENANT MANAGED CARE ALLIANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:R
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-769-0575
Mailing Address - Street 1:4415 HARRISON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HILLSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60162-1910
Mailing Address - Country:US
Mailing Address - Phone:708-432-4047
Mailing Address - Fax:708-432-0158
Practice Address - Street 1:4415 HARRISON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:HILLSIDE
Practice Address - State:IL
Practice Address - Zip Code:60162-1910
Practice Address - Country:US
Practice Address - Phone:708-432-4047
Practice Address - Fax:708-432-0158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-01
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization