Provider Demographics
NPI:1689775736
Name:PRESENCE CHICAGO HOSPITALS NETWORK
Entity Type:Organization
Organization Name:PRESENCE CHICAGO HOSPITALS NETWORK
Other - Org Name:PRESENCE HOLY FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-273-0516
Mailing Address - Street 1:100 N RIVER RD
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1209
Mailing Address - Country:US
Mailing Address - Phone:847-297-1800
Mailing Address - Fax:847-297-4348
Practice Address - Street 1:100 N RIVER RD
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1209
Practice Address - Country:US
Practice Address - Phone:847-297-1800
Practice Address - Fax:847-297-4348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0006023282E00000X
284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
No284300000XHospitalsSpecial Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0340OtherBLUE CROSS PROVIDER NUMBE
IL362439318001Medicaid
IL142011Medicare Oscar/Certification
IL0340OtherBLUE CROSS PROVIDER NUMBE