Organization
ASCENSION ST. JOHN HOSPITAL
Active
Other names
Henry Ford St. John Hospital, Lakeshore ENT Center
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL R PERRY (MANAGER)
(248) 221-1918
Entity
Organization
Contact information
Practice address
21000 E 12 MILE RD STE 111, SAINT CLAIR SHORES, MI 48081-1156
(586) 779-7610
(586) 779-0031
Mailing address
3187 SOLUTIONS CTR, CHICAGO, IL 60677-3001
(248) 680-8000
(248) 292-3852
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
—
MI
207Y00000X
Otolaryngology Physician
Primary
—
MI
207YP0228X
Pediatric Otolaryngology Physician
—
MI
207YS0123X
Facial Plastic Surgery Physician
—
MI
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
MI
207YX0901X
Otology & Neurotology Physician
—
MI
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
—
MI
Other
Enumeration date
11/15/2011
Last updated
04/16/2025
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