Provider Demographics
NPI:1184934135
Name:MERCY HOSPITAL AND MEDICAL CENTER
Entity type:Organization
Organization Name:MERCY HOSPITAL AND MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:R
Authorized Official - Last Name:POTTS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-567-2000
Mailing Address - Street 1:2801 S KING DR
Mailing Address - Street 2:APT# 805
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60616-2949
Mailing Address - Country:US
Mailing Address - Phone:312-961-1149
Mailing Address - Fax:
Practice Address - Street 1:2525 SOUTH MICHIGAN AVE
Practice Address - Street 2:MERCY HOSPITAL AND MEDICAL CENTER
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:312-567-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital