Organization
LITTLE COMPANY OF MARY HOSPITAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDACE ANN BAKER (MANAGER BUSINESS OFFICE)
(708) 229-5126
Entity
Organization
Contact information
Practice address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2746
(708) 422-6200
(708) 499-8510
Mailing address
2800 W 95TH ST, EVERGREEN PARK, IL 60805-2746
(708) 422-6200
(708) 499-8510
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
1744976
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030
BLUE CROSS
IL
Enumeration date
05/23/2005
Last updated
03/22/2010
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