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Organization
ADVOCATE ILLINOIS MASONIC HOSPITAL
Active
Organization
ADVOCATE ILLINOIS MASONIC HOSPITAL
Active
Other names
Private - Self - employeed
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN SPRAGUE RD (MANAGER NUTRITION SERVICES)
(773) 296-5194
Entity
Organization
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Mailing address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 975-1600
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
164005250
IL
Other
Enumeration date
03/04/2011
Last updated
03/04/2011
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