Provider Demographics
NPI:1720269491
Name:MOUNT CARMEL MEDICAL CENTER
Entity Type:Organization
Organization Name:MOUNT CARMEL MEDICAL CENTER
Other - Org Name:HELIO ZAPATA, M.D. SC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OB-GYN
Authorized Official - Prefix:DR
Authorized Official - First Name:HELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD SC
Authorized Official - Phone:773-486-6100
Mailing Address - Street 1:PO BOX 47259
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60647-0259
Mailing Address - Country:US
Mailing Address - Phone:773-486-6100
Mailing Address - Fax:773-486-1620
Practice Address - Street 1:1006 N WESTERN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3565
Practice Address - Country:US
Practice Address - Phone:773-486-6100
Practice Address - Fax:773-486-1620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-21
Last Update Date:2011-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036042612174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL399490Medicare PIN