Organization
STATE HOSPITAL OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOC WALKER M.D. (PRESIDENT)
(630) 227-4098
Entity
Organization
Contact information
Practice address
8461 WALREDON AVE, BURR RIDGE, IL 60527-6351
(630) 227-4098
Mailing address
8461 WALREDON AVE, BURR RIDGE, IL 60527-6351
(630) 227-4098
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
ILHOS1
IL
Other
Enumeration date
12/12/2008
Last updated
12/12/2008
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