Provider Demographics
NPI:1881855773
Name:SAINT JOSEPH HOSPITAL
Entity Type:Organization
Organization Name:SAINT JOSEPH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICAIN
Authorized Official - Prefix:
Authorized Official - First Name:SUMMAIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MUHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-865-3899
Mailing Address - Street 1:425 W SURF ST APT 610
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-6139
Mailing Address - Country:US
Mailing Address - Phone:773-865-3899
Mailing Address - Fax:
Practice Address - Street 1:2900 N LAKE SHORE DRIVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657
Practice Address - Country:US
Practice Address - Phone:773-665-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125052361281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital