Organization
THOREK MEMORIAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD BUDD (CEO)
(773) 975-6705
Entity
Organization
Contact information
Practice address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 525-6780
(773) 975-3220
Mailing address
850 W IRVING PARK RD, CHICAGO, IL 60613-3077
(773) 525-6780
(773) 975-3220
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
0005371
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001619077
BC/BS PHYSICIAN GROUP
IL
01
—
002
BC/BS
IL
01
—
809200
MEDICARE GROUP
IL
01
—
833730
MEDICARE GROUP
IL
Enumeration date
06/05/2006
Last updated
03/05/2020
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