Organization
ADVOCATE ILLINOIS MASONIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA DALY (HOUSE STAFF COORDINATOR)
(773) 296-5944
Entity
Organization
Contact information
Practice address
856 W NELSON ST APT 1905, CHICAGO, IL 60657-9204
(773) 313-5281
Mailing address
856 W NELSON ST APT 1905, CHICAGO, IL 60657-9204
(773) 313-5281
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
125057009
IL
Other
Enumeration date
07/29/2009
Last updated
07/29/2009
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