Provider Demographics
NPI:1891036984
Name:JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
Entity Type:Organization
Organization Name:JOHN H. STROGER, JR. HOSPITAL OF COOK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:MP
Authorized Official - Last Name:HOLLOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-864-5233
Mailing Address - Street 1:1900 W POLK ST
Mailing Address - Street 2:SUITE 465
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60612-3723
Mailing Address - Country:US
Mailing Address - Phone:312-864-5233
Mailing Address - Fax:312-864-9638
Practice Address - Street 1:15900 SOUTH CICERO AVE
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452
Practice Address - Country:US
Practice Address - Phone:708-687-7200
Practice Address - Fax:708-687-4198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-14
Last Update Date:2013-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.045279208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC41032Medicare UPIN