Provider Demographics
NPI:1558579557
Name:LITTLE COMPANY OF MARY HOSPITAL & HEALTH CARE CENTERS
Entity type:Organization
Organization Name:LITTLE COMPANY OF MARY HOSPITAL & HEALTH CARE CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT SUPPORT SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-422-6200
Mailing Address - Street 1:2800 W 95TH ST
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2701
Mailing Address - Country:US
Mailing Address - Phone:708-422-6200
Mailing Address - Fax:708-229-5308
Practice Address - Street 1:2800 W 95TH ST
Practice Address - Street 2:
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2701
Practice Address - Country:US
Practice Address - Phone:708-422-6200
Practice Address - Fax:708-229-5308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203624Medicare ID - Type Unspecified