Provider Demographics
NPI:1578942652
Name:ADVOCATE HEALTH AND HOSPITALS CORPORATION
Entity Type:Organization
Organization Name:ADVOCATE HEALTH AND HOSPITALS CORPORATION
Other - Org Name:LUTHERAN GENERAL HOSPITAL OLDER ADULT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GWYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOVANEC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-824-5143
Mailing Address - Street 1:9375 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4271
Mailing Address - Country:US
Mailing Address - Phone:847-296-0430
Mailing Address - Fax:847-824-8038
Practice Address - Street 1:9375 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4271
Practice Address - Country:US
Practice Address - Phone:847-296-0430
Practice Address - Fax:847-824-8038
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADVOCATE HEALTH AND HOSPITALS CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization