# ST.JOHN HOSPITAL & MEDICAL CENTER

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

## Provider details

- **NPI number:** 1275762106
- **Authorized official:** MONA ABDULLAH ALFARES M.D. (RESIDENT)
- **Authorized official phone:** (312) 823-7637

## Contact information

- **Practice address:** 19251 MACK AVE STE 335, GROSSE POINTE WOODS, MI 48236-2895
- **Practice address phone:** (312) 823-7637
- **Mailing address:** 19251 MACK AVE STE 335, GROSSE POINTE WOODS, MI 48236-2895
- **Mailing address phone:** (312) 823-7637

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | L1598766 | MI | Yes |

## Other

- **Enumeration date:** 07/13/2009
- **Last updated:** 07/13/2009