Organization
GOTTLIEB MEMORIAL HOSPITAL
Active
Parent organization
GOTTLIEB MEMORIAL HOSPITAL
Other names
Gottlieb Home Health Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOTTLIEB MEMORIAL HOSPITAL
Authorized official
MR. AJAY S. SIAL (TREASURER)
(708) 216-4252
Entity
Organization
Contact information
Practice address
905 WEST NORTH AVENUE, MELROSE PARK, IL 60160-1602
(708) 216-4983
(708) 216-0808
Mailing address
701 WEST NORTH AVENUE, MELROSE PARK, IL 60160-1602
(708) 681-3200
(708) 450-5058
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0005561
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9765
BLUE CROSS
IL
Enumeration date
08/16/2006
Last updated
04/29/2014
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