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Organization

RESURRECTION

Active
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Organization

RESURRECTION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SRIDHAR VENKATACHALAM M.D., (RESIDENT PHYSICIAN)
(847) 316-4000
Entity
Organization

Contact information

Practice address
355 RIDGE AVE, ST FRANCIS HOSPITAL, EVANSTON, IL 60202-3328
(847) 316-4000
Mailing address
311 RIDGE AVE APT 1, EVANSTON, IL 60202-3342

Taxonomy

Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
NULL

Other

Enumeration date
07/02/2008
Last updated
01/09/2009
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