Organization
ST MARY AND ELIZABETH MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN SAUCEDO MA-QMHP (ER. CRISIS WORKER COORDINATOR)
(312) 770-3501
Entity
Organization
Contact information
Practice address
3220 N KILDARE AVE, CHICAGO, IL 60641-4531
(773) 908-2242
Mailing address
2233 W DIVISION, CHICAGO, IL 60622-4531
(312) 770-3501
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
362171079
IL
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
362171079
—
IL
Enumeration date
09/14/2012
Last updated
09/14/2012
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