Organization
JOHN J. MADDEN MHC PAV-4, UNIT 4490
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FRED NIRDE (HOSPITAL ADMINISTRATOR)
(708) 338-7048
Entity
Organization
Contact information
Practice address
1200 SOUTH FIRST AVE, HINES, IL 60141-7000
(708) 338-7048
(708) 338-7233
Mailing address
1200 SOUTH FIRST AVE, HINES, IL 60141-7000
(708) 338-7048
(708) 338-7233
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
—
IL
Other
Enumeration date
02/16/2007
Last updated
07/21/2022
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