# PROVIDENT HOSPITAL OF COOK COUNTY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164522447
- **Authorized official:** PAMELA THOMAS - HALL (CFO)
- **Authorized official phone:** (312) 572-1202

## Contact information

- **Practice address:** 500 E 51ST ST, CHICAGO, IL 60615-2400
- **Practice address phone:** (312) 572-1202
- **Mailing address:** 400 VILLAGE CIR, UNIT 110, WILLOW SPRINGS, IL 60480-1802
- **Mailing address phone:** (708) 839-1833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | IL | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 08/22/2020