Organization
MISERICORDIA HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE SCHUETH (CONTROLLER)
(773) 273-4191
Entity
Organization
Contact information
Practice address
6300 N RIDGE AVE, CHICAGO, IL 60660-1017
(773) 273-4191
Mailing address
6300 N RIDGE AVE, CHICAGO, IL 60660-1017
(773) 273-4191
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
0052472
IL
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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