Organization
ROSELAND COMMUNITY HOSPITAL ASSOCIATION
Active
Parent organization
ROSELAND COMMUNITY HOSPITAL ASSOCIATION
Other names
Roseland Community Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
ROSELAND COMMUNITY HOSPITAL ASSOCIATION
Authorized official
MR. ROBERT VAIS CFO (CHIEF FINANCIAL OFFICER)
(773) 995-3000
Entity
Organization
Contact information
Practice address
45 W 111TH ST, CHICAGO, IL 60628-4200
(773) 995-3000
(773) 995-6602
Mailing address
45 W 111TH ST, CHICAGO, IL 60628-4294
(773) 995-3116
(773) 660-4505
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
208600000X
Surgery Physician
036117915
IL
208D00000X
General Practice Physician
—
—
208VP0000X
Pain Medicine Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01622034
BLUE SHIELD
IL
01
—
01622034
BCBS
—
Enumeration date
12/07/2007
Last updated
02/29/2024
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