Provider Demographics
NPI:1801975735
Name:PRESENCE CHICAGO HOSPITALS NETWORK
Entity type:Organization
Organization Name:PRESENCE CHICAGO HOSPITALS NETWORK
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:224-273-0516
Mailing Address - Street 1:2900 N LAKE SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-5640
Mailing Address - Country:US
Mailing Address - Phone:773-665-3317
Mailing Address - Fax:773-665-3460
Practice Address - Street 1:2900 N LAKE SHORE DR
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-5640
Practice Address - Country:US
Practice Address - Phone:773-572-8500
Practice Address - Fax:773-572-8568
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESENCE CARE TRANSFORMATION CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-02
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0005983314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL5448OtherBX PROVIDER NUMBER
145568Medicare Oscar/Certification