Organization
GOTTLIEB MEMORIAL HOSPITAL
Active
Parent organization
GOTTLIEB MEMORIAL HOSPITAL
Other names
GOTTIEB MEMORIAL DME
Organization subpart
Yes
Provider details
NPI number
Legal business name
GOTTLIEB MEMORIAL HOSPITAL
Authorized official
MS. ELLYN CHIN (VICE PRESIDENT OF FINANCE)
(708) 681-3200
Entity
Organization
Contact information
Practice address
675 W NORTH AVE, MELROSE PARK, IL 60160-1634
(708) 681-3200
(708) 450-5058
Mailing address
701 W NORTH AVE, MELROSE PARK, IL 60160-1612
(708) 681-3200
(708) 450-5058
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
0005561
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1671535
BLUE CROSS
IL
Enumeration date
09/01/2006
Last updated
10/19/2011
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