Organization
EDWARD HINES VA HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAJU P MATHEW RRT (RESPIRATORY THERAPIST)
(708) 202-2001
Entity
Organization
Contact information
Practice address
2217 SHANNON CT, DARIEN, IL 60561-8457
(630) 985-3548
(630) 985-3806
Mailing address
2217 SHANNON CT, DARIEN, IL 60561-8457
(630) 985-3548
(630) 985-3806
Taxonomy
Speciality
Code
Description
License number
State
286500000X
Military Hospital
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
UPINVAD000
NPPES
IL
Enumeration date
02/08/2007
Last updated
08/22/2020
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