Provider Demographics
NPI:1659475184
Name:JOHN STROGER HOSPITAL OF COOK COUNTY
Entity Type:Organization
Organization Name:JOHN STROGER HOSPITAL OF COOK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AHMAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JAJEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-864-7250
Mailing Address - Street 1:2728 N HAMPDEN CT APT 605
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6550
Mailing Address - Country:US
Mailing Address - Phone:312-864-7250
Mailing Address - Fax:312-864-9002
Practice Address - Street 1:2728 N HAMPDEN CT APT 605
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6550
Practice Address - Country:US
Practice Address - Phone:312-864-7250
Practice Address - Fax:312-864-9002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036082665282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH82967Medicare UPIN