Provider Demographics
NPI:1023100195
Name:CHRISTIAN HOSPITAL ILLINOIS SERVICES
Entity type:Organization
Organization Name:CHRISTIAN HOSPITAL ILLINOIS SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:N
Authorized Official - Last Name:KATSIANIS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:314-653-5062
Mailing Address - Street 1:8 SUNSET HILLS PROFESSIONAL CTR
Mailing Address - Street 2:
Mailing Address - City:EDWARDSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62025-3760
Mailing Address - Country:US
Mailing Address - Phone:618-659-8592
Mailing Address - Fax:618-659-8687
Practice Address - Street 1:8 SUNSET HILLS PROFESSIONAL CTR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-3760
Practice Address - Country:US
Practice Address - Phone:618-659-8592
Practice Address - Fax:618-659-8687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty