Organization
ILLINOIS MASONIC HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISE HAUSER CNM (SUPERVISOR OF CNM SERVICES)
(773) 296-3098
Entity
Organization
Contact information
Practice address
3048 N WILTON AVE, 3RD FLOOR, CHICAGO, IL 60657-6710
(773) 296-3098
Mailing address
3048 N WILTON AVE, 3RD FLOOR, CHICAGO, IL 60657-6710
Taxonomy
Speciality
Code
Description
License number
State
282NW0100X
Women's Hospital
Primary
209.010657
IL
Other
Enumeration date
09/25/2013
Last updated
09/25/2013
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