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Organization

ALEGENT CREIGHTON CLINIC

Active
Parent organization
CHI NEBRASKA
Other names
CHI Health Clinic
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHI NEBRASKA
Authorized official
DAVID PRITZA MD (SVP)
(402) 343-4477
Entity
Organization

Contact information

Practice address
800 MERCY DR, COUNCIL BLUFFS, IA 51503-3128
(855) 524-4001
Mailing address
7261 MERCY RD, ATTN: CREDENTIALING, OMAHA, NE 68124-2311
(402) 398-6255

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
208M00000X
Hospitalist Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41446
MEDICARE PTAN
IA
01
41453
MEDICARE PTAN
IA
01
41464
MEDICARE PTAN
IA
Enumeration date
01/26/2007
Last updated
09/18/2023
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