Provider Demographics
NPI:1104958859
Name:JOHN H. STROGER JR. HOSPITAL OF COOK COUNTY
Entity type:Organization
Organization Name:JOHN H. STROGER JR. HOSPITAL OF COOK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:MRS
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUFEMI
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:312-864-5145
Mailing Address - Street 1:502 YATES AVE
Mailing Address - Street 2:
Mailing Address - City:CALUMET CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60409-3165
Mailing Address - Country:US
Mailing Address - Phone:708-862-7459
Mailing Address - Fax:312-864-9650
Practice Address - Street 1:1901 W HARRISON ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-3714
Practice Address - Country:US
Practice Address - Phone:312-864-5145
Practice Address - Fax:312-864-9650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL30900185282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL30900185OtherLICENSE