Organization
ALEXIAN BROTHERS CORPORATE HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY E BREUER (ASST VP, REVENUE CYCLE)
(847) 590-7169
Entity
Organization
Contact information
Practice address
1515 W LAKE STREET, STE 100, HANOVER PARK, IL 60133
(630) 372-6103
Mailing address
1515 W. LAKE STREET, STE 206, HANOVER PARK, IL 60133
(630) 372-6103
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629944
BLUE CROSS BLUE SHIELD
IL
Enumeration date
10/19/2006
Last updated
08/22/2020
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