Organization
MISERICORDIA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DENISE TIGGES (ADMINISTRATOR)
(773) 273-3544
Entity
Organization
Contact information
Practice address
6300 N RIDGE AVE, CHICAGO, IL 60660-1017
(773) 973-6300
Mailing address
6300 N RIDGE AVE, CHICAGO, IL 60660-1017
(773) 973-6300
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0048306
IL
Other
Enumeration date
09/11/2007
Last updated
04/20/2008
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