Organization
ST. JAMES PHYSICIAN HOSPITAL ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVI SHETTY (EXECUTIVE DIRECTOR)
(708) 709-2011
Entity
Organization
Contact information
Practice address
30 E 15TH ST, SUITE #402, CHICAGO HEIGHTS, IL 60411-3459
(708) 709-2011
(708) 709-2002
Mailing address
30 E 15TH ST, SUITE #402, CHICAGO HEIGHTS, IL 60411-3459
(708) 709-2011
(708) 709-2002
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
03/27/2007
Last updated
08/22/2020
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