Provider Demographics
NPI:1922001874
Name:MICHAEL REESE MEDICAL CENTER CORP
Entity Type:Organization
Organization Name:MICHAEL REESE MEDICAL CENTER CORP
Other - Org Name:MICHEAL REESE HOSPITAL AND MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR REVEUNE CYCLE MANAGEMENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MEADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-791-3132
Mailing Address - Street 1:2929 S ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-3395
Mailing Address - Country:US
Mailing Address - Phone:312-791-2000
Mailing Address - Fax:312-791-2299
Practice Address - Street 1:2929 S ELLIS AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616-3395
Practice Address - Country:US
Practice Address - Phone:312-791-2000
Practice Address - Fax:312-791-2299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0004986282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL=========001Medicaid
IL140075Medicare ID - Type Unspecified