Organization
SAINT MARY AND ELIZABETH HOSPITAL
Active
Other names
RHS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOPHIA ZAMUDIO RASOF M.D. (FAMILY MEDICINE RESIDENT)
(847) 226-0821
Entity
Organization
Contact information
Practice address
1127 N OAKLEY BLVD, CHICAGO, IL 60622-3507
(312) 770-2040
Mailing address
1404 HACKBERRY RD, DEERFIELD, IL 60015-4021
(847) 236-0045
(847) 236-0045
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
125058811
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125058811
ILLINOIS TEMPORARY PHYSICIAN LICENSE
IL
Enumeration date
08/07/2010
Last updated
08/07/2010
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