# JESSE BROWN VA MEDICAL CENTER

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

## Provider details

- **NPI number:** 1497716922
- **Authorized official:** MISS RHETTA TURNER (ADMINISTRATIVE OFFICER, ANESTHESIOL)
- **Authorized official phone:** (312) 569-8387

## Contact information

- **Practice address:** 820 S DAMEN AVE, CHICAGO, IL 60612-3728
- **Practice address phone:** (312) 569-8387
- **Mailing address:** 1244 BEVERLY DR, LAKE VILLA, IL 60046-6408
- **Mailing address phone:** (847) 265-1654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2865M2000X | Military General Acute Care Hospital | — | IL | Yes |
| 2865M2000X | Military General Acute Care Hospital | — | WI | — |

## Other

- **Enumeration date:** 04/02/2006
- **Last updated:** 08/22/2020