Provider Demographics
NPI:1346681814
Name:JOHN STROGER JR HOSPITAL OF COOK COUNTY
Entity type:Organization
Organization Name:JOHN STROGER JR HOSPITAL OF COOK COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PGY 1
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:CANO MUJICA DE CHIRINOS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-909-3831
Mailing Address - Street 1:555 W MADISON ST APT 1806
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-2836
Mailing Address - Country:US
Mailing Address - Phone:312-909-3831
Mailing Address - Fax:
Practice Address - Street 1:627 S WOOD ST RM833
Practice Address - Street 2:
Practice Address - City:CHICAGO IL
Practice Address - State:IL
Practice Address - Zip Code:60612
Practice Address - Country:US
Practice Address - Phone:312-864-0393
Practice Address - Fax:312-864-9919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-12
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125063555282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital