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Organization
ST JAMES HOSPITAL UNITED STATES CATHOLIC CONFERENCE
Active
Organization
ST JAMES HOSPITAL UNITED STATES CATHOLIC CONFERENCE
Active
Other names
ST JAMES DIABETES
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEANNA MARIE BASS (BILLER)
(708) 755-3348
Entity
Organization
Contact information
Practice address
30 E 15TH ST, SUITE 314, CHICAGO HEIGHTS, IL 60411-3459
(708) 709-2010
(708) 755-3393
Mailing address
30 E 15TH ST, SUITE 314, CHICAGO HEIGHTS, IL 60411-3459
(708) 709-2010
(708) 755-3393
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
1813312
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046124
—
IL
01
—
1619159
BLUE CROSS BLUE SHIELD
IL
01
—
CC1471
RAILROAD
IL
Enumeration date
11/26/2007
Last updated
09/15/2008
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